%0 Journal Article
%T Quand la morale du soignant devient l¡¯¨¦thique du soin. Conflits ¨¦thiques et normes professionnelles en m¨¦decines de la reproduction et palliative Carer values and the caring ethos: ethical conflicts and professional standards in reproductive and palliative medical units Cuando la ¨¦tica de los cuidados m¨¦dicos se vuelve moral del personal m¨¦dico: conflictos ¨¦ticos y normas profesionales en las medicinas de la reproducci¨®n y paliativa
%A Philippe Bataille
%A Louise Virole
%J La Nouvelle Revue du Travail
%D 2013
%I La Nouvelle Revue du Travail
%X Cet article ¨¦tudie la mani¨¨re dont des patients discutent les r¨¨gles de la d¨¦cision m¨¦dicale en d¨¦non ant les contenus moraux des normes soignantes. Ses auteurs supposent que l¡¯¨¦thique de la d¨¦cision m¨¦dicale et du geste de soin tient ¨¤ la part subjectiv¨¦e des contenus de la relation m¨¦dicale et de soin. La d¨¦monstration s¡¯appuie sur deux enqu¨ºtes : l¡¯une r¨¦alis¨¦e avec le Centre d¡¯¨¦thique clinique de l¡¯h pital Cochin (Paris) sur les difficult¨¦s ¨¦thiques de l¡¯Assistance M¨¦dicale ¨¤ la Procr¨¦ation (Pma), l¡¯autre sur la fin de vie qui fait l¡¯activit¨¦ quotidienne d¡¯une Unit¨¦ de Soins Palliatifs (Usp). L¡¯analyse montre que la relation m¨¦dicale et de soins est perturb¨¦e par des d¨¦sordres ¨¦thiques que les normes soignantes amplifient bien plus qu¡¯elles ne les r¨¦gulent. Des patients ou leurs proches se plaignent de la violence institutionnelle qu¡¯elles g¨¦n¨¨rent et qu¡¯ils ressentent. La subjectivit¨¦ du patient s¡¯exprime jusqu¡¯¨¤ la r¨¦sistance. Toutefois, ¨¤ la plainte pour maltraitance qu¡¯il fait entendre, r¨¦pond le malaise professionnel des soignants qui s¡¯exprime ¨¤ son tour, jusqu¡¯¨¤ des crises d¡¯int¨¦grit¨¦ et de burn-out. L¡¯¨¦thique du soin est en d¨¦bat. The article studies what patients say about the rules underlying medical decision-making in their criticisms of care standards¡¯ morality. It assumes that the ethics of medical decision-making and the actual care itself can be explained by the subjective aspect of the relationship between medicine and care. Two studies are used towards this end: one involving the Cochin Hospital Center for Clinical Ethics (Paris) and dealing with the ethical difficulties faced by medically assisted-procreation services; and the other covering end-of-life experiences and daily activities at a palliative care unit. Analysis shows that medical and care relationships are disrupted by ethics disorders that caregivers¡¯ standards amplify more than they regulate. Patients and relatives often criticize and complain about the institutional violence caused by caregivers¡¯ standards, one where patients¡¯ subjectivity is expressed to the point of resistance. Complaints of malpractice are met, on the other hand, by caregivers¡¯ expressions of professional discomfort, which can go as far as to cause a crisis of integrity or burn-out. Hence the current debate about the ethics of caregiving. El presente art¨ªculo estudia la manera en que unos pacientes discuten las reglas de la decisi¨®n m¨¦dica y denuncian los contenidos morales de las normas sanitarias. Sus autores suponen que la ¨¦tica de la decisi¨®n m¨¦dica y del gesto m¨¦dico depende de la parte subjetiv
%K medical relationship
%K care value
%K professional standard
%K morality/ethics at clinical ethics
%K institutional violence
%K relaci¨®n m¨¦dico-paciente
%K valor salud
%K norma profesional
%K moral/¨¦tica
%K ¨¦tica cl¨ªnica
%K violencia institucional
%K relation m¨¦dicale
%K valeur sant¨¦
%K norme professionnelle
%K morale/¨¦thique
%K ¨¦thique clinique
%K violence institutionnelle
%U http://nrt.revues.org/613