D'une infécondite a une fécondation in vitro, parcours. . .
Institution:
Lyon 2Disciplines:
Directors:
Abstract EN:
What leads people to resort to in vitro fertilization ? What social and temporal construction underlies the successive decisions, the life histories whereby a couple ends up seeking medical advice and eventually undergoing in vitro fertilization ? When trying to understand the actual process, one should not unquestioningly assume that it is self-evident. This study deals with the time dimension of medically assisted procreation (which is also rooted in the medical institution) ; it also looks into the joint elaboration, by doctors and the two + patients ; in the consulting couple, of the successive steps taken on this course. The process involves such institutions as cecos, the social security system, or pharmaceutical firms as well as hospital and private practice. The consensus which is at the root of the + agreements ; between all those actors is itself based on several elements :. There is first a shared perception of infertility as a biomedical problem admitting of technical solutions. We have here a hyperactive, technologically oriented conception of medicine, which particularly appeals to women working at the lower levels of the hospital hierarchy ;. A lot of importance is devoted to + hospital ; time, a time of urgent medical decisions, ruled by strict schedules. Simultaneously, this + hospital ; time is often considered as being one with + natural ; time ;. A wish to keep as close as possible to the + biological ; pattern ; this leads to keeping in vitro fertilization for couples made up of a man and a woman. Still, there remain contradictions : all the practices involved in medically assisted procreation can hardly be justified by science alone. Technical procedures tend to undermine the conception of a + natural ; time for procreation and a + biological ; procreation unit. Those are the contradictions the medical profession has to overcome before its role in this new field can be seen as legitimate. Beyond the difficulties faced by individual mds, what is at stake, in fact, is the evolution of social norms, a broader issue which touches on society as a whole.
Abstract FR:
Comment se fait le recours aux techniques de fecondation in vitro ? Comment se construisent, socialement et dans le temps, ces decisions successives, ces parcours de vie qui amenent, un jour, un couple a consulter a l'hopital pour sterilite puis a effectuer une fecondation in vitro ? Il s'agit d'approcher la realite des processus sans presupposer trop fortement de leur automaticite, de leur evidence. Les dimensions temporelle et institutionnelle de l'assistance medicale a la procreation sont abordees en meme temps que l'elaboration conjointe, par le medecin et le couple de + patients ;, des moments de cette + trajectoire ;. Sont impliques aussi bien des structures comme la securite sociale, les firmes pharmaceutiques ou le cecos que l'organisation hospitaliere et les rapports entre l'hopital et la medecine de ville. Il semble que le consensus fondant + l'accord ; entre les differents acteurs repose sur plusieurs piliers :. Une representation commune de l'infecondite, probleme biomedical dont la solution est technique ; c'est une conception hyperactive, ou techniciste, de la medecine qui est a l'oeuvre et a laquelle adherent tout particulierement les femmes occupant une position subalterne dans la hierarchie hospitaliere ;. Une importance forte accordee au temps de l'hopital, temps de l'urgence technique, du programme qui fait loi, souvent assimile, dans le discours, au + rythme naturel ; ;. Le desir de ne pas s'eloigner du + modele biologique ; de la procreation, qui conduit a reserver l'acces de ces techniques a un couple forme d'un homme et d'une femme. Des contradictions n'en demeurent pas moins : il est difficile de justifier exclusivement par des arguments scientifiques l'ensemble des pratiques de l'assistance medicale a la procreation ; l'artifice technique a tendance a faire eclater les limites + naturelles ; du temps de la procreation aussi bien que l'unite + biologique ; de procreation. La profession medicale est confrontee a ces contradictions pour legitimer son intervention dans ce nouveau domaine. Au-dela des difficultes rencontrees par les medecins, se trouve posee la question de la transformation des normes qui concerne le corps social tout entier.