Contenu du sommaire

The somatoform disorder in chronic pain : the medical legal translation of a psychiatric category Since the 1990s, the granting of invalidity pensions to the persons suffering from chronic painful syndromes and from psychological troubles arouses lively debates in the Swiss context. In the opinion of the political authorities, because these cases would have contributed to the financial deficit of the insurance, they should henceforth be the object of stricter evaluations. Among the identified diagnoses as uncertain from the medical legal point of view, the somatoform disorder in chronic pain is doubtless the one which was the most discussed by the experts. The objective of this article aims at describing the process by which this nosologic entity became a legal category. This translation was considered necessary because of the medical controversies which were current on this diagnosis and which complicated the work of the judges, in to confront them at the risk of making arbitrary decisions. It will be a question of describing the shaping of the problem from the reflections and the etiologic hypotheses moved by experts psychiatrists. The attempt of conciliation of their epistemic sensibilities was tempted by a judge who formalized the legal criteria of appreciation of the chronic painful syndromes. So was born a case law analyzed in a research from which arises this article.

When reanimation fails : the experience of the families How do families build their experience of resuscitation when it fails, in spite of ongoing progress in that field ? This article deals with how families give sense to this experience a few months after the death of a relative or a close friend. It shows on one hand that irrespective of the uniqueness of each case, families experience a phase of hope, which tends to dissolve as time goes by ; and on the other hand, that this experience is marked with a feeling of uncertainty which questions the concept of trust, as much in professionals as in the system of care as a whole.

A new map of the normal and the pathological. The institutionalization of mental health in the United-States The article examines the tensions involved in the development of treatment for mental disorders during the period 1950-1980 in the United-States. It relates those tensions to the diffusion of an ideal strongly influenced by the subjectivist fervor characteristic of post-war America but also internally contradictory. Psychiatric diagnosis came to be seen as a way of disqualifying the individual, but this context also worked to identify psychic disorder with an incomplete self, and this new orientation led to a substantial increase in demand for treatment. The article first considers the antagonism between these representations as suggested by the effects they had on professionalization and the division of labor in the psychiatric field. It then seeks to show how the standards established at the end of the period— the famous DSM-III— by offering a means of negotiating the different visions of mental disorder, has institutionalized a new map of the normal and the pathological under the flag of “ mental health”.