[Restorative Justice: Neither care nor repression? The case study of Louis, a multi-recidivist, neither "dangerous" nor "sick"]. / La Justice restaurative : ni soigner, ni réprimer ? Le cas Louis, multirécidiviste ni « dangereux ¼ ni « malade ¼.

OBJECTIVES: The proposed criminological hypothesis is that the restorative justice approach would allow offenders to recognize the victims with more empathic feelings, assuming a decreasing effect on the needs and risks of recidivism (Griffiths and Murdoch, 2007). Authors of aggravated robbery raise several psychological issues (i.e. incomprehension of the causes of their act, euphemistic labelling and moral disengagement, lack of empathy) that the restorative program proposes to work through scriptwriting of personal histories, better comprehension of the conflict in the past and exchanges focused on the personal and social consequences of the acts (emotional chain). The aim of the process is to encourage persons weakened by their social and delinquent situations to elaborate, plan and realize new personal goals. METHODOLOGY: With the collaboration of the service de l'application des peines de Tours (service for the execution of sentences), the service pénitentiaire d'insertion et de probation 37 (probation and social reintegration service) and the service d'aide aux victimes d'infractions pénales (association for victims of crime) of the French department 37, centre, the program PARIS attempted an implementation and evaluation of the relational or restorative justice process in the context of non-custodial sentences and in particular in the cases of aggravated theft (art. 311-1 to 311-16 of the French penal code). Its particularity was to touch the three spheres of victimization: (1) financial, (2) physical and (3) psychological prejudices. After the admission of the participants, a preliminary (psycho)criminological diagnosis served to evaluate the suitability for the perpetrator and the victim to be confronted in following settings. In this context we met Louis, a recidivist of aggravated thefts but causing minimal harm and punished with minimal sentences. He presented no mental illness but showed severe existential problems involved in his delinquent behaviour. His delinquent acts presented similarities marked by auto-punitive tendencies. For example, he remained on site until being arrested and joked with the police. RESULTS: The case Louis revealed what neither the care nor repression succeeded to reach, namely the quality of the relationship which can in itself confine or on the contrary repair. Relational Justice, by seeking neither to "suppress" nor to "care", allows the participants to reconstruct and understand the other with empathy, and strengthened the protective factors. Mediation as a method or purpose held a prominent place in the reconstruction process of the participants as it allowed us to act on both the "frame" (scenario of the problem-situation) and the "drama" ((non)-effectiveness of cognitive strategies and experienced emotions) of the original problem-situation. So the restorative program was an alternative to the socio-judicial measures inducing potential therapeutic effects on the future path of the participant. CONCLUSION: If the question of the relevance of direct, or perhaps better indirect, confrontations between the author and the victim still remains the (psycho-)criminological diagnosis of the penal couple's - author and victim - relationship investigates the psychosocial and delinquent process in terms of motivation. A satisfaction survey at the end of the program helps to analyse the future prospects of the participants. Based on dynamic and structured methods, the PARIS relational Justice program offers a Third Way between care and punishment: restoration of existential and relational links.

Is Patient Education About Adhesions a Requirement in Abdominopelvic Surgery?

Background: Over the past decades, our knowledge and understanding of adhesions and adhesion-related complications has increasingly grown and it has become evident that adhesions have significant implications for patients, physicians and the healthcare system. The question arises whether this has resulted in greater awareness of adhesion-related problems among practicing physicians and appropriate patient education on this topic in daily practice. The following article provides a brief overview of the important subject of adhesions, discusses current awareness of adhesions among patients and doctors and addresses the consequences of failure to provide patient education and consent from a medical perspective. Methods: Selective literature searches were conducted in PubMed and the Cochrane Library. A patient information and consent form was developed based on several years' experience and expertise in the field of adhesions. Results: Adhesions are the most common type of complication in abdominopelvic surgery today, with devastating consequences for some patients. Surveys investigating the awareness of adhesions among physicians and patients clearly showed that even well-informed physicians fail to educate their patients adequately. Such failure could potentially lead to successful medical malpractice lawsuits against doctors. Conclusion: Considering their clear clinical impact, adhesions and related consequences should always be discussed with patients preoperatively. A newly developed consent form that specifically addresses adhesion formation may serve to thoroughly educate patients preoperatively and to adequately document the process of doing so.