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The psychologist working in an institution plays a specific role within a multidisciplinary team, where skills are multiple but complementary. As part of a holistic approach, the psychologist's position in relation to other team members, the different functions he or she occupies and his or her ethical responsibility are essential elements in the support provided. Whether supporting professionals or caring for patients, the psychologist brings unique resources to the relational space., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Experienced on a personal and psychological level, work related stress nevertheless has social causes. New forms of management demand from staff an ever greater personal investment, but the growing intensification of the work often makes the missions they are given impossible to fulfil. This results in a feeling of having failed and of not being up to the job, which are in turn sources of suffering and stress., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

The "patients' rights and end-of-life care" act, known as the Leonetti law, has allowed implementation of palliative care in neonatology as an alternative to unreasonable therapeutic interventions. A palliative care project can be offered to newborns suffering from intractable diseases. It must be focused on the newborn's quality of life and comfort and on family support. Palliative care for newborns can be provided in the delivery room, in the neonatal unit, and also at home. Going home is possible but requires medical support. Here we describe the potential benefits of the intervention of a regional team of pediatric palliative care for newborns, both in the hospital and at home. Two clinical situations of palliative care at home started in the neonatal period and the neonatal unit are presented. They are completed by a retrospective national survey focusing on the type of support to newborns in palliative care in 2014, which was conducted in 22 French regional pediatric palliative care teams. It shows that 26 newborns benefited from this support at home in 2014. Sixteen infants were born after a pregnancy with a palliative care birth plan and ten entered palliative care after a decision to limit life-sustaining treatments. Twelve of them returned home before the 20th day of life. Sixteen infants died, six of them at home. The regional pediatric palliative care team first receives in-hospital interventions: providing support for ethical reflection in the development of the infant's life project, meeting with the child and its family, helping organize the care pathway to return home. When the child is at home, the regional pediatric palliative care team can support the caregiver involved, provide home visits to continue the clinical monitoring of the infant, and accompany the family. The follow-up of the bereavement and the analysis of the practices with caregivers are also part of its tasks., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

The Chair of Philosophy at Hôtel-Dieu hospital in Paris, is a place for the sharing of knowledge and recognition. It provides a place where the subjective, institutional and political dimension of care can be considered, by all stakeholders: patients, nurses, families and citizens. The aim is to invent a shared nursing function., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Nursing practice encounters a number of areas of uncertainty which are not entirely assuaged by the legal framework or best practice recommendations. Caregivers must demonstrate lucidity and sincerity, with regard to themselves and their patients, and undertake humanist and ethical reflection. Announcing a serious diagnosis is the first difficult stage of a complicated and painful experience, shared between the patient, the family or institutional carers and the health professionals., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Within the psychiatric hospital, the caregiver is faced with difficult choices regarding the <> to respond to the suffering of the patient, to accompany him and sometimes forcing him to accept care. The hospital is a place of pressures from within and from outside, where the caregiver must perform a balancing act, with multiple conflicting roles. He must respect patient rights and his resources, his safety and those of others, the understanding of his difficulties, the expectations of the family and the limits of reality. This care has a fundamental ethical dimension. The team discussion allows for a conflictual cooperation between caregivers, which makes possible caring for our patients in crisis.

Introduction: Prematurity is one of the etiologies for severe neurological complications. Decisions to withdraw therapeutics, including artificial nutrition and hydration (ANH), are sometimes discussed. But can one withdraw ANH if the patient is a child suffering from severe neurological conditions, based on his best interests? The aim of this study was to further the understanding of the complexity of the withdrawal of ANH and its implementation in the neonatal intensive care unit (NICU)., Method: This qualitative preliminary study based on a questionnaire was conducted on the staff in the NICU of the Pontoise medical center (France) in February 2012. The results were compared with the current knowledge on this issue and sociological data., Results: Ten of the hospital staff members responded to the questionnaire: 60% considered ANH as a treatment, but the status of ANH (i.e., treatment or care) remained undefined for several respondents. Comparison with the withdrawal of mechanical ventilation or adult practices seemed to be inadequate. The staff had little experience in the domain and therefore few certainties on practices. Half of the respondents indicated that terminal sedation needed to be used. For the other half, it depended on the patient's pain. Timing was also an important notion given that the newborn is a being developing and evolving each in its own way., Conclusion: The withdrawal of ANH remains controversial in the NICU. Humanity, culture, and the relationship to others are ever present in the decision-making process, creating a moral opposition above and beyond ethical reflection., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

With the ageing of the population, dementia has become a public healthcare priority. A network designed to help the families of patients suffering from dementia on a medical as well as a social and psychological level has been set up. This structure has been developed in close coordination with community practitioners and physicians and in line with the latest recommendations in particular with regard to ethics. Its first three years of existence confirm the importance of this type of approach which complements the care provided by hospitals.

In France, the law dated 22 April 2005 required that all practitioners offer palliative care to patients as an alternative to unreasonable obstinacy. The practical development of palliative care during the neonatal period is not easy, even though obstetricians and neonatologists have always been aware of the ethical necessity of comfort in the dying newborn. The decision leading to palliative care begins with the recognition of patent or potential unreasonable obstinacy, followed by withdrawing treatment and technical support, and finally a palliative care plan is drawn up with the medical team and the parents., (Copyright 2010. Published by Elsevier SAS.. All rights reserved.)

Palliative care in newborns may take place in the delivery room and then continued either in maternity wards or in the neonatal unit. For babies developing a chronic condition, going home may be advantageous. The population concerned includes babies born with a severe intractable congenital malformation and certain extremely preterm newborn babies at the limits of viability. Care procedures as well as withholding and withdrawing treatments are reviewed., (Copyright 2010. Published by Elsevier SAS.. All rights reserved.)

Several new French regulations have come into effect to regulate the healthcare of juvenile offenders in prison with the creation of French Young Offender Institutions. They complete the French prison healthcare methodological guide. This article presents the new developments in the healthcare of juveniles in prison. It specifies the limitations placed on the healthcare team's interventions on imprisoned juveniles. Promoting an individualized prisoner program, as is done in the school context, outlining parental involvement in this program, and withdrawing from the healthcare methodological guide the tasks that are not within the realm of the physician caring for the minor would be measures to ensure good ethical medical practices in prison. These could be applied to French secure training centers and secure children's homes., (Copyright 2009 Elsevier Masson SAS. All rights reserved.)

External supervision of teams is increasingly part of mechanisms put in place both in public networks and community organizations to contribute in supporting professional mental health workers in developing their abilities and improving their clinical practices. It also plays a role in the analysis of ethical questions and in the prevention of deontological errors. The supervision of teams also includes its share of challenges, notably with regards to group dynamics and mechanisms to favour in order for supervision to rightly adjust to the needs and levels of participating professionals. Finally, the supervisor must also consider his own ethical responsibilities towards those supervised and towards their clients.

This article wants to be a contribution reflecting on the theme of applied ethics aiming at nourishing professional and interdisciplinary practices. The authors examine the process of ethical deliberation which has four major ends : the development of reflective and ethical competences of professionals, the elaboration by professionals, of an ethical reflective structure facilitating professional praxis, orientation and quick coordination of action ; implementation of a structure of collective deliberation useful in the orientation of difficult decisions and future actions. Finally, this process also has an objective of evaluation and appears relevant in the apprenticeship drawn from experiences of each participant.

General principles of medical ethics are discussed in the context of care for patients with severe dementia.

Background: Head and neck cancer occupies an important place in the field of oncology in France (8%). Patient management requires a wide diversity of treatment modalities and must be based on a multidisciplinary approach., Materials and Methods: This clinical ethics study was based on analysis of a national survey of current practise in public and private hospital structure. A 28-questions anonymous questionnaire was send to 164 practitioners caring for these patients from the stage of diagnosis and evaluated the modalities of dental treatments and the related ethical aspects., Results: The competence of the various practitioners in their respective fields is undeniable, but there is a lack of multidisciplinary collaboration. The absence of an oral practitioner is a serious problem and can reduce the patient's chances of cure., Discussion: The oral practitioner must participate in head and neck cancer committees at all steps of treatment in order to provide curative, preventive care and prosthetic rehabilitation, thereby contributing to improvement of the quality of life of these patients.