[Ethics, care and ageing during the Covid-19 pandemic]. / Éthique, soin et grand âge pendant l'épidémie de Covid-19.

At the beginning of the Covid-19 epidemic, National forum for ethical reflection on Alzheimer's disease and neurodegenerative diseases conducted a national survey to identify the difficulties encountered by professionals working in the field of old age and autonomy, families and volunteers, and the initiatives they have implemented. Seven major difficulties were identified: the isolation induced by the prohibition of visits, the lack of protective equipment and tests, the difficulties of people with cognitive difficulties in understanding measures to avoid the spread of the epidemic, the sustainability of overwork for professionals, the concern of the families of residents, complex situations at home and difficulties in accessing care. Four initiatives are being implemented: information and training for teams, compensation for interrupted visits, consultations and exchanges between professionals, actions to benefit people living at home. The Covid-19 epidemic hit the elderly sector at a very special moment in its history, several years of effort by the sector to reinvent itself around strong values. They have been a resource during this period of crisis. An ambitious law on old age and autonomy therefore appears to be a necessity.

Care and prejudice: moving beyond mistrust in the care relationship with addicted patients.

Social representations of addiction and the resulting stigmatization have been widely described and studied in the literature, but their effects are no less problematic. These representations, which also occur in care settings, generate a climate of distrust which damages the therapeutic relationship, and its ethical quality. This article, combining clinical experience and an ethical stance, offers an original, innovating approach to the existence of distrust in care relationships in the area of addiction. Pragmatic approaches deriving from the human sciences and analytical philosophy provide an invitation to escape from the demanding climate of mistrust, and to take the gamble on trust so as to improve the quality of interactions between protagonists in care. In complementary fashion, a sociology of action can combat the disquiet generated by distrust through a new commitment to innovating forms of action. This "poetic" mode of action is legitimized by the reflection that backs it up, and by its presentation to peers qualified to approve it. Finally, continental moral philosophy underlines the importance of a carefully weighed commitment on the part of caregivers and addicted patients towards promises aiming to support a sincere care relationship, without damaging the therapeutic dynamic or the ethical quality by providing too many safety nets. This reflection is intended to achieve better identification of the clinical and ethical issues raised by mistrust, and inclusion of these aspects in the training of personnel and in care provision planning.

["Espace national de réflexion éthique sur la maladie d'Alzheimer--EREMA". Another approach to Alzheimer's disease and ethical responsibility]. / L'espace national de réflexion éthique sur la maladie d'Alzheimer. Une autre approche de la maladie et de la responsabilité éthique.

The creation in 2010 of a national ethical area on Alzheimer disease illustrates the evolution in the French context towards an institutionalization of ethical approach concerning chronic diseases and long term care. This paper presents the background of such a national area, how it works, its objectives and two concrete outputs: the charter "Alzheimer Ethics & Society 2011" and the advice "Alzheimer, ethics and society", published in September 2012.

[Analysis of the concept of risk in a medical teaching program]. / L'analyse de la notion de risque, base d'un enseignement médical.

The concept of risk has acquired an extremely important place in medical care in the course of various social developments. This concept plays a role in the physician-patient relationship, especially as the form in which the physician provides information to the patient; it is also a form of medical knowledge. We propose a cross-sectional medical course module on this concept of risk, intended for medical students; it can be included in module 1 of the curriculum for the national ranking examination. This class enables a new approach to medical care by showing the variety of definitions of risk and facilitating their perception and integration. Through a process that is simultaneously epistemological and practical, it aims to associate the medical knowledge we use every day with the concept of risk and thereby help the students take a critical distance relative to the mass of available knowledge. This approach to medical knowledge through the concept of risk makes the knowledge more operational and more pertinent within the context of individual clinical situations and thus optimizes medical care. Its pedagogical techniques combine standard classroom lectures with workshops involving role-playing in specific scenarios. This original course meets the needs of medical students who are in the process of becoming health care providers--needs related to the analysis and use of available medical knowledge in their clinical practice and to some aspects of the patient-provider relationship.

[HIV-AIDS: ethics in healthcare, research, and access to treatments]. / VIH-sida: éthique du soin, de la recherche et accès aux traitements.

Violence and gravity cannot be ignored when considering HIV and AIDS challenges. However, coping with this pandemic disease caused us to build up and experience new ways of solidarity that have transformed our views of medical care and public health. The few achievements of these years throw a new light on the figure of the ill person. They brought new references allowing a different understanding of the political stakes of public health. Partnership or even therapeutic alliance are now a framework to the understanding of respect, solidarity and equity. New viewpoints exist on the health care relationship. Our achievements show at first injustice in the access of treatments at the international level. They make clear our moral responsibilities toward every person that require a treatment. This idea should be emphasized when applied on the most vulnerable communities. The most urgent challenges that remain today are extreme precariousness situations, treatment access conditions, information, and quality of life.