Ethique & sante最新文献

{"title":"De la fidélité au serment d’Hippocrate","authors":"A. de Broca ,&nbsp;C. Hazif-Thomas","doi":"10.1016/j.etiqe.2024.06.004","DOIUrl":"10.1016/j.etiqe.2024.06.004","url":null,"abstract":"<div><p>Prêter serment est un moment important pour celui qui s’engage. Il est alors tenu d’honorer celui-ci en suivant les principes inscrits dans le serment. Le serment est parfois obligatoire pour exercer une profession, comme pour les futurs médecins qui doivent le faire juste après avoir passé leur thèse d’exercice. Que faire si la société change et amène à ce que le serment ne soit plus adapté à la demande sociétale ? Que faire si le législateur modifie les lois mettant en contradiction les termes du serment et la loi nouvelle ? Quelle est la liberté de la personne assermentée dans ces situations ? Comment être fidèle au serment ou être fidèle à soi-même du fait de ses convictions si celles-ci sont en contradiction avec les termes déontologiques exprimés dans le serment ? Le droit de retrait face aux injonctions législatives peut-il être un moyen de suivre son serment dans une société mouvante ? Notre propos tente d’apporter quelques réponses à ces questions.</p></div><div><p>Taking the oath is an important moment for those who take the oath. He is then required to honor it by following the principles and codes enshrined in the oath. The oath is sometimes obligatory to practice a profession, as for future doctors who must take it immediately after having successfully passed their practical thesis. What to do if society changes and leads to the oath no longer being adapted to societal demand? What to do if the legislator modifies the laws putting the terms of the oath in contradiction with the new law? What freedom does the sworn person have in these situations? How to be faithful to the oath or be faithful to oneself because of one's convictions if these are in contradiction with the ethical terms expressed in the oath. Can the right of withdrawal in the face of legislative injunctions be a way of following one's oath in a changing society? Our remarks attempt to provide some answers to these questions.</p></div>","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 3","pages":"Pages 211-217"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709390","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’utilisation du placebo dans les essais cliniques est-elle légitime ?","authors":"","doi":"10.1016/j.etiqe.2024.05.002","DOIUrl":"10.1016/j.etiqe.2024.05.002","url":null,"abstract":"<div><p>L’objectif de cet article est d’interroger la légitimité de l’utilisation d’un groupe placebo dans les essais cliniques randomisés (ECR). Après avoir distingué les questions scientifiques et épistémologiques des questions proprement éthiques autour de l’utilisation du placebo dans les ECR, l’auteur défend une plus grande place accordée à l’autonomie des malades : en leur permettant, premièrement, de décider plus librement à quels tests ils veulent participer. Deuxièmement, en améliorant les outils d’évaluation et de promotion de cette autonomie utilisés par les équipes de recherche. Troisièmement, en précisant, dans les directives anticipées, la question de la participation future à la recherche, afin de ne pas laisser la personne de confiance et les proches démunis.</p></div><div><p>The aim of this article is to question the legitimacy of using a placebo group in randomized clinical trials (RCTs). After distinguishing between the scientific and epistemological issues and the purely ethical questions surrounding the use of placebo in RCTs, the author argues for greater emphasis to be placed on patient autonomy: firstly, by allowing patients to decide more freely which tests they wish to take part in. Secondly, by improving the tools used by research teams to assess and promote patient autonomy. Thirdly, by specifying, in advance directives, the question of future participation in research, so as not to leave the trusted support person and next of kin at a loss.</p></div>","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 3","pages":"Pages 225-232"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141045648","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 consécration légale de l’aide à mourir doit assurer la conciliation de l’intimité du malade et de l’approche collégiale de la fin de vie","authors":"","doi":"10.1016/j.etiqe.2024.05.004","DOIUrl":"10.1016/j.etiqe.2024.05.004","url":null,"abstract":"<div><p>La légalisation de l’euthanasie et/ou du suicide assisté va-t-elle déchirer le principe de fraternité qui vient tempérer celui de l’autonomie tendue à l’extrême vers l’autodétermination ? Viendra-t-elle consacrer une mutilation de la loi Claeys-Leonetti ou promouvoir une avancée des libertés éclairant ses qualités propres à rassurer chacun dans notre démocratie sanitaire ? Ces questions recouvrent celle du recours à la collégialité dans la pratique de l’aide à mourir, comme impératif procédural, au risque de perdre le sens du dialogue intime du médecin avec le mourant. Revenir à la délibération éthique est d’autant plus précieux qu’elle engage chacun dans un dialogue approfondi et ouvert sur un projet qui s’adapte finement à chaque cas, sa casuistique donc étant d’un usage très souple. Faut-il légiférer dès lors tandis qu’on peut craindre qu’une loi ne puisse jamais être en mesure de résoudre l’ensemble des situations singulières ? L’équilibre à trouver est probablement des plus précaire entre l’incontournable respect de l’intimité et l’indispensable collégialité dans cette volonté d’instituer la mort choisie comme nouvelle règle du bien mourir.</p></div><div><p>Legalization of Medical Assistance in Dying Will it tear apart the principle of fraternity which tempers that of autonomy stretched to the extreme towards self-determination? Will this enshrine a mutilation of the Claeys-Leonetti Law or promote an advance in freedoms enlightening its own qualities to reassure everyone in our health democracy? These questions include the use of collegiality in the practice of assisted dying, as a procedural imperative, at the risk of losing the sense of the physician's intimate dialogue with the patient at the end of life. Returning to ethical deliberation is all the more valuable as it engages everyone in a thorough and open dialogue on a project that adapts finely to each case, its casuistry therefore being of a very flexible use. Should we legislate then while we can fear that a law can never be able to solve all the singular situations? The balance to be found is probably the most precarious between the unavoidable respect for intimacy and the indispensable collegiality in this will to institute the chosen death as new rule of the good to die.</p></div>","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 3","pages":"Pages 233-243"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141400047","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","authors":"L. Marcucci ,&nbsp;E. Borgnis Desbordes","doi":"10.1016/j.etiqe.2024.07.001","DOIUrl":"10.1016/j.etiqe.2024.07.001","url":null,"abstract":"","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 3","pages":"Pages 175-176"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044805","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":"While medicine has to be correct scientifically and not politically, medical education should be free to those who deserve","authors":"","doi":"10.1016/j.etiqe.2024.02.002","DOIUrl":"10.1016/j.etiqe.2024.02.002","url":null,"abstract":"","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 3","pages":"Pages 244-245"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140785259","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 plurivocité du serment","authors":"C. Draperi","doi":"10.1016/j.etiqe.2024.06.006","DOIUrl":"10.1016/j.etiqe.2024.06.006","url":null,"abstract":"<div><p>Il s’agit dans l’exploration de la plurivocité du serment médical, de dégager la portée éthique commune au texte antique et à ses réécritures postérieures dans des moments historiques cruciaux. Dans un premier temps, nous proposons une interrogation concernant la fonction du serment attaché au nom d’Hippocrate, en vue de circonscrire la nature de son enjeu premier. Dans un second temps, sont abordées les réécritures contemporaines majeures du serment, après la révolution française, puis à l’issue du troisième Reich. Cette lecture anthropologique vise à éclairer l’enjeu éthique que le serment conserve dans l’horizon contemporain.</p></div><div><p>In exploring the multivocality of the medical oath, the aim is to identify the ethical significance common to the ancient text and its subsequent rewritings in crucial historical moments. Firstly, we question concerning the function of the oath attached to the name of Hippocrates, to circumscribe the nature of its primary issue. Secondly, we adress major contemporary versions. This anthropological reading aims to shed light on the ethical issue that the oath still has today.</p></div>","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 3","pages":"Pages 192-195"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141843369","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 théorie morale implicite du serment d’Hippocrate","authors":"P. Le Coz","doi":"10.1016/j.etiqe.2024.06.005","DOIUrl":"10.1016/j.etiqe.2024.06.005","url":null,"abstract":"<div><p>Hippocrate est demeuré célèbre pour avoir été le premier à doter la clinique d’une méthode rigoureuse, capable de satisfaire aux exigences de la raison. Figure paradigmatique de l’émergence du rationalisme en Occident, contemporain de Socrate et de Platon, le père de la médecine a aussi marqué de son esprit de rigueur un « serment » promis à une grande fortune. Par sa vocation « performative », le serment est animé d’une finalité qui diffère de celle de la déontologie dont les normes sont régies par des préoccupations d’ordre réglementaire et juridique. Plus que de la déontologie, il est pertinent de rapprocher le serment des théories morales qui composent le paysage philosophique de l’éthique d’aujourd’hui. Indépendamment du contenu de ses règles, le discours hippocratique se prête à une réflexion sur sa tonalité globale et sa cohérence interne. De sa « substantifique moelle », il est possible de dégager une certaine manière de concevoir l’éthique qui fait encore sens de nos jours. En tant que vision éthique d’ensemble, la pensée philosophique d’Hippocrate pondère une théorie morale déontologiste par une éthique de la prudence.</p></div><div><p>Hippocrates remains famous for having been the first to provide the clinic with a rigorous method, capable of satisfying the demands of reason. A paradigmatic figure in the emergence of rationalism in the West, a contemporary of Socrates and Plato, the father of medicine also marked with his spirit of rigor an “oath” promised to great fortune. Through its “performative” vocation, the oath has a purpose that differs from that of deontology, the standards of which are governed by regulatory and legal concerns. More than deontology, it's relevant to compare the oath to the moral theories that make up the philosophical landscape of ethics today. Regardless of the content of its rules, the Hippocratic discourse lends itself to reflection on its overall tone and internal coherence. From its “substantial marrow”, it's possible to extract a certain way of conceiving ethics which still makes sense today. As an overall ethical vision, Hippocrates’ philosophical thought balances a deontological moral theory with an ethics of prudence.</p></div>","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 3","pages":"Pages 177-182"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044597","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":"Sommaire","authors":"","doi":"10.1016/S1765-4629(24)00090-4","DOIUrl":"10.1016/S1765-4629(24)00090-4","url":null,"abstract":"","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"21 3","pages":"Page iii"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1765462924000904/pdfft?md5=2499fd7bc87d3366b8a621189277fd85&pid=1-s2.0-S1765462924000904-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044659","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":"","authors":"L. Marcucci","doi":"10.1016/j.etiqe.2024.07.005","DOIUrl":"10.1016/j.etiqe.2024.07.005","url":null,"abstract":"","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"22 1","pages":"Pages 70-71"},"PeriodicalIF":0.0,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471632","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.2024.07.004","DOIUrl":"10.1016/j.etiqe.2024.07.004","url":null,"abstract":"","PeriodicalId":72955,"journal":{"name":"Ethique & sante","volume":"22 1","pages":"Page 72"},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141853063","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}