Amputations: Un cycle de l’éthique médicale

Abstract

Amputation is a surgical procedure that often highlights a failure in management of infection or in the accompaniment of a disease such as diabetes. It raises a question of identity for the patient. Reconstructive surgery reduces the identity issues. Although the benefit received by the patient, reconstructive surgery is not the one coming first. The history of amputation is relatively well known (Kirkup, 2007). Why a so ancient practice? Why a so abundant practice today - in particular, more than 1,200 amputations performed in few days in January 2010 in Port au Prince? Alternative surgical techniques have been developed parallel to amputation. Large progress in medical history led to a fall in the death rate, but not a reduction in the variety of therapeutic practices. Two models of interpretations can be used to explain the variation of the surgical practices: either a cycle with recurrences, or a succession of phases. In L’Usage des plaisirs, Michel Foucault explains how the Hippocratic medicine induces the setting of the first professional ethics. The history of sexuality is a succession of phases. However, the analytical form of a cycle seems to be confirmed by the analysis in the case of the history of amputation. This ethical cycle consists of general recommendations in low phase and an ethical decision in high phase.