Rapport 24-05. Comprendre la place de l’irrationalité dans le soin : quelles conséquences pour la pratique et la formation des soignants ?

Abstract

A significant number of people are turning to unconventional therapies, sometimes to the detriment of their health. The motivations are numerous: dissatisfaction with the health system and its stakeholders, particularly due to a loss of meaning in care, a feeling of distrust towards science, misleading information and conspiracies spread on social networks. In such a context, caregivers may feel helpless in the face of behavior that they judge to be clearly irrational. The irrationality of behavior is, however, a delicate concept to handle and which must be considered with caution in the context of the doctor-patient relationship. When meeting a patient, the question of the finitude of life is never totally absent. Building a therapeutic alliance often involves taking this reality into account. The “Académie nationale de médecine” reminds that clinical practice is based on the mastery of highly scientific and technical knowledge, mobilized in the context of a dialogue between two human beings, each imbued with his or her own subjectivity. Practical actions are proposed in this report, in the areas of clinical practice, training of caregivers, information for patients and more generally for citizens. This is an issue of major importance to guarantee a care system that is both caring and effective, necessary conditions to avoid the use of certain potentially harmful alternative care. It is under such conditions that our healthcare system will be truly “rational”.