| Le partenariat de soin avec le patient : analyses |  |
2 | 1er semestre 2021
Ce second numéro propose une série d’articles sur la place du patient au XXIe siècle, à l’ère du partenariat. Ce thème ouvre un axe de recherche juridique dont la légitimité est renforcée par la première recommandation d’une recherche financée par l’Union Européenne sur le patient partenaire de soin (INTERREG APPSS) menée dans quatre États membres dont la France.
1. Du patient-formateur au médiateur de santé-pair : histoire d’une formation universitaire ancrée dans la cité
Information to the patient about his state of health and its possible consequences, as well as the need to request his consent to deliver the necessary care are recent achievements. For centuries, in the name of medical paternalism, doctors have preferred not to reveal to patients information relating to their state of health so as not to alarm them unnecessarily. Since then, the Kouchner law of March 4, 2002 seemed to “introduce a role reversal” (Gridel, 2002) by putting the consent of the person in the foreground andt he therapeutic necessity in the background. New care strategies have also emerged in response to societal expectations. The patient-healthcare professional partnership is one of them. His goal? Promote the expertise derived from the patient's experience of the disease and consider the latteras a full member—a partner—of the care team. Paris 8 University has supported this movement by setting up diploma courses. Its partnership with Côte d'Azur University is now a major new step with the application of an integrated patient-partnership model in the training of health professionals.
2. Démocratie et engagement en santé
After strong social mobilization in France, the States General of Health met in 1998 and 1999 to come up with a law consecrating health democracy. Extended to democracy in health, it is based on the proclamation of individual rights and methods of representation of users of the health system in regulatory bodies reserved for approved associations. This prospect has had the effect of leaving aside the participation of all in social and medico-social care and support, on the one hand, and in public debate, on the other. It is in this context that ascientific recommendation from the Haute Autorité de Santé outlines the prospects for commitment to health for all, in a participatory approach with all stakeholders in the health system.
3. De la création d’un contexte du partenariat de soin avec le patient possible pour chaque citoyen, à la professionnalisation de patients au service de l’intérêt général
One of the manifestations of the power of patients, relatives and citizens to act concerning their health and participation in the general interest that more and more of them over time is now recognized by some authors as asocial fact, by others like the blockbuster of the 21st century, is noted by the number of publications on the subject at the global level because produced in an anthropogenic way. The aim of this article is first to describe the contours of what has developed in terms of patient postures and qualifications in recent decades before proposing the lines of research that appear necessary to frame and promote the development of what has been recommended by the World Health Organization for more than three decades.
4. Co-construction entre usagers et professionnels dans la recherche et le soin
This article explores the changes currently underway in the field of mental health. We historically explore the metamorphoses since the second half of the 20th century regarding a new conception of mental disorders. Thus, we come back to the transformation of patient status induced by these new approaches. These new paradigms influence both the legal tool and the practices of care and research. In this way, we question this evolution in order to understand what it could tend towards in the future. Finally, to support these many changes which tend towards a balance between users and professionals, we propose to think about the conception of a mixed knowledge that can be used by both professionals and users.
5. Paradoxes de l’exercice de la pair-aidance en santé mentale en France : entre expérience prometteuse et pratique contestable
This article, written by one of the first qualified peer health mediators following the completion of the first training course initiated by the Collaborating Centre of the World Organisation of Mental Health Europe and the University Paris 8 Vincennes Saint-Denis, sheds light on the contributions, limitations and paradoxes of his new activities and their institutionnalisation in France with his critical gaze fed by 8 years of experience of this profession.
6. Pour une vision du soin en adéquation avec son temps et son appropriation par les populations et leurs organisations
This article sheds light on the current state of affairs and the challenges involved in the development of the patient care partnership, and more broadly the and more broadly, the cultural changes involved in engaging patients and populations in their care and health systems. It how this is organized in Quebec, the results obtained ten years after the emergence of the concept of care partnership with the with the patient and the implementation challenges it faces.
7. L’exercice médical à travers les mutations et l’émergence du partenariat de soin avec le patient
This article sheds light on the changes facing the practice of medicine, whether of a societal and technological, epidemiological and relational nature, and proposes a comprehensive approach to deal with them.