Shared decision making in the physician-patient encounter in France: a general overview in 2011.

WHAT ABOUT POLICY REGARDING SDM? There is a social demand in France for more healthcare user information and greater patient participation in the decision making process, as reflected by the law of March 4(th) 2002 pertaining to patients' rights and the quality of the healthcare system known as the Law on Democracy in healthcare. WHAT ABOUT TOOLS - DECISION SUPPORT FOR PATIENTS? At the micro level, some research projects are being developed, some of them using decision aids. Preliminary results show that patients want to be informed but that the concept of shared decision making needs to be analysed and refined from both the patients' and the physicians' points of views. WHAT ABOUT PROFESSIONAL INTEREST AND IMPLEMENTATION? However, the relationship between physicians/healthcare professionals and patients/healthcare users is very complex and progress in this field takes time. Only ten years after enactment of the Law on Democracy in healthcare, it might be premature to try and determine the state of the art of shared medical decision making at the macro and meso levels in France. WHAT DOES THE FUTURE LOOK LIKE? There is room in France for further studies on shared decision making in the medical encounter. Researchers, decision makers, healthcare users and healthcare professionals need a place to meet and exchange. An observatory dedicated to shared decision making will be launched in the coming months, both at the national level and in collaboration with several other French-speaking areas like Switzerland and the province of Quebec.

[Interests of applied anthropology to oncology]. / Les apports de l'anthropologie appliquée au champ de la cancérologie.

From now on the introduction of social and human sciences studies in the field of oncology has not always been conclusive. This article aims to analyze the bounds that border the meeting and the understanding between physicians, patients and anthropologists. It also treats the problems due to the introduction of applied anthropology in the field of oncology and points up the interests and practical contributions that this disciplinary bring and could bring.

[Patients and physicians: cross representations anthropological study of the construction of individuality in radiation therapy]. / Soignant contaminé et malade imaginé: étude anthropologique de la construction de l'individualité en radiothérapie.

The methods of anthropology allow us to understand group dynamics by bringing to light a web of linked causalities in order to describe human and social relationships. The density and dimension of the relationship with a patient have direct repercussions on professional motivation. But this proximity has its drawbacks. The process of identification to patients is inevitable and the fear of "contamination" is not medical but symbolic: it is expressed in the difficulty of appreciating the distance, the difference between the "other" (the patient) and the self (the physician). Health professionals have therefore to find a delicate compromise between proximity and strategies of distance. The temptation is therefore great, of considering the patient only through his pathology. This "imagined patient" allows the clinician to define the frames structuring his relation to the patient. But at the same time, this creates a loss of identity for the patient. In this context, the relation between patient and clinician should be based primarily on a necessary individual acknowledgement of the patient who expresses it in a re appropriation of his illness. Thus he sets himself as an actor of the therapeutic relation and no longer as an object of clinical care.