Towards a clinical philosophy of hand and face allografts : history, epistemology, ethics
Author(s)Dumont , Martin
Contributor(s)La République des savoirs : Lettres, Sciences, Philosophie ; Département de Philosophie - ENS Paris ; École normale supérieure - Paris ( ENS Paris ) -École normale supérieure - Paris ( ENS Paris ) -Centre National de la Recherche Scientifique ( CNRS ) -Collège de France ( CdF )
PSL Research University
KeywordsHistory of transplantation
Epistemology of transplantation
Composite tissue allografts
Histoire des greffes
Epistémologie des greffes
Allogreffe de tissus composites
[ SHS.PHIL ] Humanities and Social Sciences/Philosophy
[ SHS.HISPHILSO ] Humanities and Social Sciences/History, Philosophy and Sociology of Sciences
[ SDV.ETH ] Life Sciences [q-bio]/Ethics
[ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology
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AbstractThis work aims at building a clinical philosophy of transplantations, especially in regards to hand and face allografts; this means a philosophy rooted in the experience of care and that of the patients. The history of the establishment of transplantation as an efficient procedure, from the beginning of the twentieth century to the 1960s, is examined: it helps understand the unexpected challenges that had to be met, and how these procedures are subject to precise and restrictive conditions. This critical epistemology then allows to approach the ethical questions raised by composite tissue allografts. These procedures have given birth to intense debate, to which the clinic has already partially brought answers. But other ethical problems remain, which are considered by describing the delicate conditions for choosing the procedure and by interrogating the norms legitimating this risky procedure as a cure for severe handicaps.
Ce travail s’efforce d’élaborer une philosophie clinique des greffes, particulièrement des greffes de mains et de visage ; c’est-à-dire une philosophie qui repart toujours de l’expérience du soin et des patients. L’histoire de la constitution des greffes comme soin efficace, du début du vingtième siècle aux années 1960, y est examinée : elle permet de percevoir les obstacles inattendus qu’il a fallu apprendre à surmonter, et combien ces procédures reposent sur des conditions précises et contraignantes. Cette épistémologie critique permet ensuite d’aborder les questions éthiques soulevées par les greffes de tissus composites. Celles-ci ont suscité d’importants débats, auxquels la clinique a en partie apporté des réponses. Mais des questions éthiques subsistent, qui sont abordées en décrivant les conditions délicates du choix de la procédure et en interrogeant les normes qui légitiment de recourir à ce soin risqué pour le traitement de handicaps graves.
NNT : 2017PSLEE084
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