Ethician...
L’éthicien, s’il existe…
Résumé
Care involves two types of relationships that should not be opposed but rather instilled into a dialectic: (1) An indirect relationship, organized, planned for better efficiency and safety of care. (2) A direct relationship in which the care giver-care receiver dialogue takes place. The former is source of an organizational ethics managed by an "ethician" whose objective is, extremely, to reduce Adverse Events Associated with Care. The second favors ethics as a form of moral heroism consisting in reverting adverse events into "desirable" events.
However our modernity signs a pluralism of thought leading professionals to deal with increasingly complex situations, original and sources of ethical and practical conflicts. Conflicts that oblige to reinvent a new syntax of acting within ethical institutional spaces (Committees or ethical reflection groups).
However, it is not enough that ethics has a place for it to take place. Rather than thinking how to think or how to implement ethics, this article questions the very identity of the ethician: does the ethician exist or do only ethics exist?
Our purpose is to show that despite all the subjectivity due to the story of a clinical situation, only the research work and backing by documentary evidence allows an ethician, among which it is the role, to develop a high-levelled subjectivity. It transforms a clinical situation in an ethical observation instituted by raising the track into the dignity of document, and the past into the dignity of historical fact. The question is to know what distinguishes a good from a bad subjectivity in order that, ultimately, ethical observation become completed only in the reader of this work (Committee members or Group members, health professionals, students, patients, citizens). The work of resumption is the foundation of a narrative based medicine (NBM) and a narrative ethics (NE) that allow opening the field of possibilities of acting for patients and caregivers.
An ethician job that makes ethics and therefore the ethician as well. But an ethician, if there, who will face one of the major challenges of the coming decades: to participate in the implementation of an economic democracy in order to question with citizens and in confrontation with politicians the Man that we will build tomorrow.