Plaidoyer contre l'anamnèse psychiatrique

Few practices have been subject to as little scrutiny in psychiatry as the taking of patients’ medical histories. That said, it must be noted that most information collected upon taking patient medical history proves unjustified in terms of timely clinical actions to be taken by medical professionals. Such information could thus be deemed excessive, as it goes beyond what is useful from a pragmatic, or clinical, standpoint. If lacking in clinical utility, what purpose does such data serve? The process of taking medical history can be examined through the prism of its power-related function, rooted in the dominant position assumed by doctors and caregivers, who collect information irrelevant to the patients’ needs with regard to their request for care. One might view this as part of what Foucault calls the regimes of truth. A regime of truth compels individuals to carry out a number of acts of truth, thereby determining the obligations of the said individuals in terms of their manners of expressing the truth. The regimes of truth include, for instance, rituals in the form of theatrical ceremonies called “alethurgias” and an array of verbal and non-verbal procedures meant to embody truth. According to Foucault, in ancient times there were three regimes of truth, and two of which are especially relevant to taking medical history, namely the veridiction of the gods and the veridiction of slaves. The thesis is hereby put forward that taking medical history is a derivative of the veri­diction of slaves

Substitution aux opiacés : programme de la dernière chance ou pari sur la qualité de vie ?

Les traitements de substitution qui ont contribué à une politique de réduction des risques efficace doivent actuellement également s’inscrire dans une addictologie «existentielle». Celle-ci donne une place centrale à l’élaboration d’un projet de vie pour la personne souffrant d’addiction. C’est autour de ce projet que les actes de soins vont s’inscrire. Dans cette perspective, la question du thérapeute prenant en soins des patients souffrant d’addiction ne va plus être seulement de prescrire un traitement de substitution, mais surtout pour quels objectifs le prescrire. Ce passage d’une réflexion visant à la survie à une réflexion de soins orientée vers la vie nous impose de passer d’une logique d’urgence avec réponse immédiate pour un patient «passif» à une logique de crise demandant au patient une participation active à son processus de rétablissement

Two decades of the Swiss program based on the prescription of Diacetylmorphine, from a public health intervention to a treatment option

The medical prescription of diacetyl morphine (heroin) treatment is an addition to the therapeutic arsenal for patients gravely dependent or addicted to heroin use and for whom other forms of therapy have failed. In Switzerland, the Federal Office of Public Health SFOPH) has established directives and recommendations concerning prescription and administration of diacetyl- morphine