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Article ID: CBB001250801

Aspirations éthiques et réalité de la pratique médicale à la fin de l'Ancien Régime (2012)

Canadian Bulletin of Medical History/Bulletin Canadienne d'Histoire de la Medecine
Volume: 29, no. 1
Issue: 1
Pages: 29-48

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a survie économique était difficile pour les médecins de la fin du 18e siecle. Trop nombreux, en concurrence avec les autres soignants, ils devaient soigner leur apparence pour acquérir une bonne réputation et se faire une clientele. Une attention particuliere a leur habillement et a leur moyen de transport participaient a l'établissement de la réputation de bon docteur et devait leur permettre d'attirer un réseau de patients suffisant. Toutefois, ce réseau ne garantissait pas encore la sécurité financiere du médecin et de sa famille. Encore fallait-il, a une époque ou les tarifs médicaux commencent a etre discutés seulement, savoir sur quels criteres rédiger la facture de ses honoraires, et comment se faire payer par leurs malades. A cette meme époque parurent les premiers textes imprimés sur les recommandations éthiques médicales, qui insistent sur la modestie, la délicatesse, l'authenticité et la sincérité. Cet article, par la confrontation entre archives personnelles et prescriptions éthiques, montre les tensions qui existent entre les difficultés quotidiennes de la pratique médicale et les recommandations éthiques, tensions qui ont des conséquences sur la relation thérapeutique. Abstract. At the end of the 18th century, economic survival was difficult for physicians. The medical market was crowded and to build (and seduce) a clientele, they had to pay particular attention to their appearance. Being well dressed and travelling by horse or in a carriage was necessary to demonstrate that they had a good reputation and were a good doctor. However, this still did not guarantee financial security for the doctor and his family. In an era when medical fees were only just beginning to be discussed, it was difficult to know how to bill patients and how to get paid. At the same time, the first texts on medical ethics appeared, insisting on modesty, authenticity, delicacy, and sincerity. In this article, by exploring personal archives and printed moral prescriptions, I will suggest that there were tensions between the everyday difficulties of medical practice and the recommendations on medical ethics, tensions that had consequences for the patient-doctor relationship.

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