Les actes de soins et l’appauvrissement moral de la médicine

CAMBRIDGE – les actes de soins sont considérés comme une “charge” par les économistes, comme un “processus de lutte” par les psychologues cliniciens ; ce sont des coûts de santé pour les chercheurs et des compétences cliniques pour les médecins. Mais beaucoup estiment que les actes de soins sont une composante fondatrice de l’expérience morale. Ils font appel à la reconnaissance, à l’imagination empathique, à la capacité de témoigner, au sens des responsabilités, à la solidarité. Ce sont les formes les plus concrètes d’assistance. C’est cette considération morale qui fait que ceux qui prodiguent les soins, et parfois ceux qui les reçoivent, se sentent “présents”, et donc plus humains.

Mais si l’on excepte la qualité des soins effectués par les infirmiers, les efforts de rééducation des physiothérapeutes, ou l’assistance pratique des assistants sociaux et des aides à domicile, les soins, spécialement ceux prodigués aux victimes d’accidents de santé et aux personnes en fin de vie, ont relativement peu à voir avec la pratique actuelle de la médicine.

Je peux m’appuyer sur ma propre expérience pour illustrer cela car je m’occupe de mon épouse qui souffre d’une maladie neurodégénérative sévère. Elle est devenue dépendante depuis que ce mal a fini par atteindre sa mémoire et ses fonctions motrices. Je la réveille le matin, je l’assiste dans sa toilette, pour le bain et pour l’habiller, je nous prépare notre petit-déjeuner et l’aide à se nourrir. Je l’aide à marcher, à s’asseoir, et à s’installer dans notre voiture. Je suis presque toujours avec elle pour faire en sorte qu’elle ne se fasse pas mal car elle ne peut ni voir ni évoluer de façon sure dans la rue ni même dans notre propre maison. 

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