ods_dr-house.jpgLes erreurs médicales causent plus de morts que le cancer du sein, les accidents de la route ou le SIDA, aux États-Unis ( Kohn & al., 2000) et probablement au Canada. Cette statistique, publiée à l’Académie des sciences des États-Unis, n’est évidemment pas clamée haut et fort par le corps médical, et les médias de masse, trop habitués à reproduire fidèlement ce que les chercheurs leur disent, ne présentent pas fidèlement la situation, dans toute sa gravité.

Il existe un précepte selon lequel la confiance entre le médecin et le patient ne doit pas être rompue, sans quoi rien ne va plus. Ce précepte devra malheureusement être mis de côté.

La profession médicale est en train d’évoluer. Les jeunes générations (et notamment les jeunes femmes, sans cependant tomber dans les stéréotypes), permettent d’espérer que la situation évolue.

Cependant, il faut comprendre que la formation médicale est actuellement conçue de telle manière qu’elle inhibe le dévelopemment moral des jeunes aspirants médecins (Patenaude & al., 2003). Ce phénomène est unique dans le monde universitaire. Si ces naufrages psychologiques ne sont pas évités, c’est la population qui continuera à payer.

Comme les études de médecine font qu’une vaste proportion des médecins fraîchement diplômés adhèrent à une morale bloquée au stade conformiste, il ne tient qu’aux citoyens de leur faire comprendre que la médecine telle qu’on la pratiquait ne leur convient plus.

Références

Patenaude J, Niyonsenga T, Fafard D. Changes in students’ moral development during medical school: a cohort study. Canadian Medical Association Journal. 2003 Apr 1;168(7):840-4.

It seems reasonable to infer that a levelling effect occurred in moral reasoning over the 3 years of medical education. This levelling raises many questions of concern to medical students and their teachers that need to be addressed in further longitudinal studies. Such studies would help to differentiate the effect of peer influence, institutional influence and the influence of the system of medical education on the development of students’ moral reasoning. The challenge will be to develop a curriculum that will enable medical students to at least maintain their stage of moral development if not increase it through the medical education experience.

Kohn, Linda T., Corrigan, Janet M. , and Donaldson, Molla S., Editors. (2000) To Err Is Human: Building a Safer Health System; Committee on Quality of Health Care in America, Institute of Medicine

Health care is not as safe as it should be. A substantial body of evidence points to medical errors as a leading cause of death and injury.

• Sizable numbers of Americans are harmed as a result of medical errors. Two studies of large samples of hospital admissions, one in New York using 1984 data and another in Colorado and Utah using 1992 data, found that the proportion of hospital admissions experiencing an adverse event, defined as injuries caused by medical management, were 2.9 and 3.7 percent, respectively. The proportion of adverse events attributable to errors (i.e., preventable adverse events) was 58 percent in New York, and 53 percent in Colorado and Utah.

• Preventable adverse events are a leading cause of death in the United States. When extrapolated to the over 33.6 million admi ssions to U.S. hospitals in 1997, the results of these two studies imply that at least 44,000 and perhaps as many as 98,000 Americans die in hospitals each year as a result of medical errors. Even when using the lower estimate, deaths in hospitals due to preventable adverse events exceed the number attributable to the 8th-leading cause of death.Deaths due to preventable adverse events exceed the deaths attributable to motor vehicle accidents, breast cancer or AIDS.

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