This article examines HIV-positive patients’ experiences of treatments within a context characterized by the multiplicity of opinions expressed both by specialists and the public domain. It is based upon a survey of 63 patients encountered in a Paris hospital. The authors demonstrate the contrasts between these patients in terms of two main dimensions: the degree of the patients’ proximity to specialist knowledge, and the level of homogeneousness that the patients attribute to medical know-how. At the point where these two dimensions (...) meet, the article distinguishes between three forms of patient attitude towards treatment; in other words, three ways of simultaneously positioning oneself with regard to the media, associations, doctors and family circles/entourage: resorting to exteriority; self-integration into biomedical institutions; arranging heterogeneous actors. It analyses the transformations relating to the main experience profiles highlighted by sociological studies of other pathologies. (shrink)

Victim compensation now plays a central role in dealing with harm. It can be brought into play by various devices: private or social insurance, the courts or special funds created for specific disasters. With each device, compensation raises complex evaluation issues: is it appropriate to use financial compensation to repair harm? Who should pay and on what basis should the compensation be awarded? What is the nature of the damage? How to evaluate it and how to value the amount of (...) compensation determined? These questions are the subject of intense work of evaluation by both those who create or implement the compensation devices and by those who use them. This article looks more specifically at this work of evaluation by people who have endured a collective disaster and who have had to deal with the devices designed to compensate them. (shrink)

ArgumentThe article is based on the controversies relating to conducting experiments and licensing AIDS treatments in France in the 1980s and 1990s. We have identified two political operators, i.e. two issues around which tensions have grown between the different generations of actors involved in these controversies: 1) the way of thinking about patient autonomy, and 2) the way in which objectivity regarding medical decisions is built. The article shows that there are several regimes of objectivity and autonomy, and that it (...) is at the meeting point of the two dimensions that very different political forms of medicine have developed. In the case of AIDS, the article identifies four of these forms (liberal and conservative clinical traditions and therapeutic modernity – enclosed, then participative) and analyzes the dynamics of their emergence and opposition. We discuss an “objectivity/autonomy” diagram as a conceptual framework which enables us (above and beyond AIDS) to think about changes in contemporary medicine. (shrink)