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SummaryThe behaviour of the medical profession in Quebec provides a typical example of Eliot Freidson's hypothesis concerning occidental societies, in which the medical profession tends to succomb to two forms of deviance: the extension of its power outside of the field of so-called medical expertise and the bankruptcy of its promiseof service to the community. The social consequences of this state of affairs and their social determinations are discussed with the help of both statistics and of what is known about the practice of medicine in Quebec. The medical creed of community service cannot realize its full potential in a mercantile society where to it social structures and ideology are inherently opposed.

When categories of actors are discredited, epistemic inequalities produce testimonial or hermeneutic injustices. These injustices manifest themselves in the absence of recognition of the knowledge of others and in the fact that their ability to understand is called into question. Moreover, although they are subjected to exogenous norms in which they do not find themselves, the people subjected to these injustices find it difficult to assert this and to identify their own norms. These two types of injustice alter the quality of care relationships, particularly in terms of relational ethics, by eroding the trust between caregivers and patients. In order to counteract these, a pedagogical experiment based on democratic and epistemic logics was proposed to health students. This experiment has three pillars: teaching on the partnership between health professionals and patients, patients as teachers or mentors and patients as colleagues. These three pillars are presented as interrelated, one not going without the other. On the democratic level, the aim is to rebalance the power relationships. Thus, it is patients who recruit patients and the latter have a status. At the epistemic level, the aim is to rebalance knowledge relationships, which involves questioning knowledge and standards in terms of their consequences on patients, or more precisely on the “patient experience”. Two different and complementary pedagogical programs have been implemented to create a pedagogical experience within a medical faculty (Sorbonne Paris Nord University) located in the city of Bobigny, which is now called the “Bobigny experience”. The aim of the first is to use the “patient perspective” to resolve clinical situations, while the second is to use narrative medicine to combine the experiences of students and patients on specific topics.

Keywords: injustices épistémiques, relation médecins-malades, éthique relationnelle, pédagogie, pragmatisme, patients-mentors, patients-enseignants, epistemic injustices, physician-patient relationship, relational ethics, pedagogy, pragmatism, patient-mentors, patient-teachers

SummaryThe article examines the debates surrounding the emergence of the term biomedicine, with a particular focus on the relation between the pathological and the normal. The authors reject simplistic definitions of biomedicine as a one-way street leading to the application of medical knowledge to medicine, or even as a two-way street characterized by iterative exchanges between the clinic and the laboratory. Rather, the authors introduce the notion of a biomedical platform as the site where the clinic and the laboratory intermingle and are realigned in connection with the ongoing process of medical innovation and the increasing automation of molecular procedures. The examples used in the article are drawn mainly from the field of onco-hematology.

This article presents the results of qualitative exploratory research on the meaning of the recourse to alternative medicine (chiropractic, acupuncture, homeopathy, hypnotherapy, osteopathy, etc.) by Montreal users. The recourse to such other therapies is seen to indicate more than the desire to cure an illness that medicine cannot help any further, to signify something other than a request for treatment. It is the expression of a quest for well-being which embodies a need to make sense of illness and life. The reasons for turning to alternative medicine thus correspond less to a logic of therapeutical effectiveness than to a need for attention, listening and understanding, and to a search for meaning, a need to both believe in and understand what is happening.

Introduction Substance use among resident physicians is an underestimated, poorly understood, and serious problem because of its negative consequences for the health of physicians and also for the health and safety of the patients in their care.

Keywords: médecins résidents, Maroc, substances psychoactives, addiction, facteurs de risque, resident physicians, Morocco, psychoactive drugs, addiction, risk factors

Au cours des dernières décennies, le Burkina Faso, pays du Sahel, a fait face à un enchaînement d'événements climatiques «extrêmes» d'une ampleur et d'une rapidité sans précédent. On peut penser notamment aux sécheresses récurrentes, à la pluviométrie insuffisante et mal répartie, à la hausse des températures ainsi qu'à l'abaissement ou l'assèchement total des eaux souterraines qui alimentent les sources. Sans contredit, ces événements ont de lourdes conséquences au niveau bio-physique et socio-économique. Au Burkina Faso, la médecine traditionnelle est un héritage millénaire. Tout un chacun a recours à cette médecine locale, fiable et adaptée à un moment ou à un autre. On compte au nombre des impacts des variations climatiques affectant le pays la perte de biodiversité ainsi que la migration vers le sud de …

AbstractP.-J.-O. Chaveau's Charles Guérin, which takes place in 1830, contains several medical figures. Making use of a juxtaposition of a fictional text and the history of Quebec medicine, the author examines science, the Book, medical practice and particularly the feeling of helplessness shared by those physicians faced with the cholera epidemic that ravaged Canada in 1832.