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Du tri à l'autre : éthique et médecine d'urgence

Abstract : How to approach medical ethics at the time of the great confusion between business ethics, morals, ethics, ethics of biomedicine, applied ethics, ethics of care, meta-ethics, bioethics ...? Perhaps by a return "to the things themselves" as Husserl would have said, a return to medicine itself to find in its “nest” the ethics of medicine and not the fabricated ethics that would ultimately and definitively become ethics for medicine.A particular type of practice, emergency medicine, allows to study the procedure, its power and its updates (in the sense that these terms are in Aristotle) and its intersections with the technical movement. What is a medical procedure, what is a technical movement and how can we distinguish them? Also, how can we recognize an act without a gesture and a gesture without an act? It's the doctor, author of the act, that makes the act a medical procedure. Even when the technical gesture covers an entire act, it can only be distinguished from the medical procedure if the applicant is not a doctor, doctor being intended not in the statutory sense but as in the holder of medical knowledge (episteme). The act with no gesture met in medical regulation is evidence that emergency medicine is not limited to technical moves.Like many disciplines in science policy, emergency medicine tends to transform time into space to better quantify its practice but it eventually has to face the necessity of adaptation to other medical specialties. The truth, which is reduced to mathematical accuracy, gives para-clinics the central place of medical practice, gradually separating patients away from their physician.The triage, unique exercise in mass medicine and disaster medicine, is unexpected proof of medical ethics. The categorization of victims, which is a principle of triage, is a reflection of heightened rational thought. Because thinking is sorting. The advent of third parties in the doctor-patient relationship limits medical liability, which would otherwise be unbearable. The infinite responsibility of everyone vis-à-vis the other, intensified by the role of nursing, precedes and is at the origin of freedom. The Third party makes it impossible to do the impossible for others, it forces to share. Introduced at the time of triage, it gives the opportunity to politics to be deeply rooted into ethics.
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Pierre Valette. Du tri à l'autre : éthique et médecine d'urgence. Philosophie. Université Paris-Est, 2011. Français. ⟨NNT : 2011PEST0074⟩. ⟨tel-00714219⟩

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