Essai d'une approche comparative entre le droit français et le droit sénégalais. L'une des particularités du 21e siècle durant ces dernières décennies est indéniablement le progrès scientifique qui a réalisé de grandes prouesses dans plusieurs domaines, comme celui de la médecine. La personne humaine est au coeur de ces bouleversements scientifiques et la question de sa vulnérabilité se pose lorsqu'il s'agit plus particulièrement de l'enfant malade.
Au-delà des traitements médicaux, la protection de l'enfant malade implique une prise en compte de la recherche médicale et comporte dès lors des enjeux internationaux qui méritent une étude comparative notamment entre le droit français et le droit sénégalais.
Based on interviews with Senegalese people living in four contemporary urban neighbourhoods, who had experienced the death of an adult family member, we explore how the research challenged and surprised the White, British members of the research team. Such challenges help to shed light on some dominant, taken-for-granted understandings of ‘bereavement’ based in ‘Western’ perspectives. The surprises include how the death was discussed and explained; patterns of family living and the implications for how individuals responded to the death; the emotional significance of particular religious expectations; and the emotional implications of material hardships. After exploring how interviewees responded to the deaths in Senegal, we consider how these responses compare with expectations and taken-for-granted assumptions about ‘bereavement’ in the contemporary UK. We conclude by discussing the implications for bereavement support and professional practice, in relation to diverse responses to death.
Despite calls for cross-cultural research, Minority world perspectives still dominate death and bereavement studies, emphasizing individualized emotions and neglecting contextual diversities. In research concerned with contemporary African societies, on the other hand, death and loss are generally subsumed within concerns about AIDS or poverty, with little attention paid to the emotional and personal significance of a death. Here, we draw on interactionist sociology to present major themes from a qualitative study of family deaths in urban Senegal, theoretically framed through the duality of meanings-in-context. Such themes included family and community as support and motivation; religious beliefs and practices as frameworks for solace and (regulatory) meaning; and material circumstances as these are intrinsically bound up with emotions. Although we identify the experience of (embodied, emotional) pain as a common response across Minority and Majority worlds, we also explore significant divergencies, varying according to localized contexts and broader power dynamics.
BACKGROUND: In sub-Saharan Africa, the literature on end of life is limited and focuses on place of death as an indicator of access and utilization of health-care resources. Little is known about population mobility at the end of life.
OBJECTIVE: To document the magnitude, motivations and associated factors of short-term mobility before death among adults over 15 years of age in Burkina Faso and Senegal.
METHODS: The study was based on deaths of adult residents reported in three Health and Demographic Surveillance System (HDSS) sites in urban (Ouagadougou) and semi-rural areas (Kaya) of Burkina Faso, and rural areas of Senegal (Mlomp). After excluding deaths from external causes, the analysis covered, respectively, 536 and 695 deaths recorded during the period 2012-2015 in Ouagadougou and Kaya. The period was extended to 2000-2015 in Mlomp, with a sample of 708 deaths. Binary logistic regressions were used to examine the effects of socio-demographic characteristics on place of death (health facility or not) and location of death (within or outside the HDSS).
RESULTS: In Mlomp, Kaya and Ouagadougou, respectively 20.6%, 5.3% and 5.9% of adults died outside the HDSS site. In Mlomp and Kaya, these deaths were more likely to occur in a health facility than deaths that occurred within the site. The reverse situation was found in Ouagadougou. Age is the strongest determinant of mobility before death in Mlomp and Kaya. In Mlomp, young adults (15-39) were 10 times more likely to die outside the site than adults in the 60-79 age group. In Ouagadougou, non-natives were three times more likely to die outside the city than natives.
CONCLUSIONS: At the end of life, some rural residents move to urban areas for medical treatment while some urban dwellers return to their village for supportive care. These movements of dying individuals may affect the estimation of urban/rural mortality differentials.
CONTEXT: With prevalence of non-communicable diseases and life expectancy rising in Senegal, the need for palliative care is likely growing. No national palliative care needs assessments have been carried out.
OBJECTIVES: To assess the capacity and need for palliative care in Senegal.
METHODS: A multi-component assessment of availability and demand for palliative care was conducted in two tertiary and two regional hospitals in Senegal in 2015 with approval from Senegal's National Ethics Committee for Health Research. The assessment consisted of (1) an inpatient hospital census; (2, 3) surveys of inpatients and outpatients with life-limiting illness; (4) a knowledge, attitudes, and practices survey among healthcare workers; and (5) a facility survey to assess availability of palliative care medications.
RESULTS: Nearly half (44.4%) of all inpatients (n=167) had an active life limiting illness. Among them, 56.6% reported moderate to severe pain in the past three days, 2.3% of whom received morphine and 76.7% received weak or no pain medication. Inpatients also experienced moderate to severe dyspnea (42.1%), fatigue (66.5%), nausea (16.5%) and drowsiness (42.1%). 39.2% of all outpatients (n=395) reported moderate to severe pain, and 52.8% said the treatment they had received relieved their pain only partially or not at all. Two-thirds of all doctors reported feeling comfortable prescribing pain medicines, however 83.0% rarely or never prescribed morphine. Two of four hospitals reported no use of morphine in 2014.
CONCLUSION: There is significant need for palliative care in Senegal. Training of healthcare workers and ensuring availability of relevant medications should be prioritized.
Emprunté au domaine de la philosophie morale, la dignité a fait l'objet d'une inscription dans les textes juridiques, notamment internationaux, à la suite de la Shoah. Ainsi, aujourd'hui, le principe de dignité humaine préoccupe aussi bien les juristes que de nombreux publics allant des représentants de multiples disciplines aux simples citoyens en passant par les politiques. En effet, le contenu de ce concept reste indéterminé. Mais peut-il en être autrement sachant que la dignité humaine pose une question centrale : qu'est-ce qui fait la valeur de l'existence humaine ? Dans ce contexte, cet ouvrage tente de relever un défi : analyser les applications du principe de dignité dans vingt pays représentatifs de cultures différentes pour tenter de cerner son contenu et surtout d'apprécier son utilité en droit.
Les Wolof du Sénégal aiment la vie au point de devenir "thanatophobes". Sous ce rapport, ils mettent en oeuvre une gamme de pratiques rituelles qui, au demeurant, les aide à mieux exorciser le démon de la "mort néantisation". A cet égard, nous sommes amenés à penser que cette quête, parfois exacerbée, de la vie n'assure l'éternité qu'aux hommes au détriment des femmes qui, dans cette perspective, sont, tout simplement, les "laissées pour compte".
Interview de M. Magaud, éducatrice, originaire du Sénégal. Elle est venue en France, s'est mariée et a perdu son mari il y a un an et demi. L'accompagnement rituel de sa famille du Sénégal lui a beaucoup manqué au long du deuil.