title: [One more word about the diagnostic. A metapsychological approach].
abstract: Nearly a decade since the first experiment in France of the so-called "announcement policy" a concerted effort, the pooling of skills of health professionals from different backgrounds, have had noticeable positive effects on the daily practice. This article attempts at analyzing the question that was causing the application of former patients and their main complaint: the lack of communication and its direct consequences, anguish and loneliness. Subsequently, the announcement policy, this multifaceted approach, had consisted of creating for the patient what can be called "a good enough environment able to hold". It is therefore not a plan but a disposal (if we are willing to agree on the fact that these are the qualities of the therapeutic setting that count and not the format by itself). Considering the ipseity of each patient, the uniqueness of each particular situation, of each social background, the need for harmonization of the announcement policy is questionable. Harmonization does not mean uniformity. The quality of this policy must be adapted closer to each case. However, it must be based on the basic principles and might also take into account the dimension of anguish. These fundamental principles are directly derived from the principles of medical humanism, those that have brought meaning to scientific progress.
authors.affiliation: Hôpital Arnaud de Villeneuve, avenue du Doyen-Giraud, 34295 Montpellier cedex, France; UFR médecine, sciences du sujet et de la société, laboratoire Epsylon EA 4556 dynamique des capacités humaines et des conduites de santé, STAPS universités Montpellier et St-Etienne, université Paul-Valéry Montpellier III, route de Mende, 34199 Montpellier cedex 5, France. Electronic address: jl-pujol@chu-montpellier.fr.
authors.forename: J-L
authors.initials: JL
authors.lastname: Pujol
authors.affiliation: Hôpital Arnaud de Villeneuve, avenue du Doyen-Giraud, 34295 Montpellier cedex, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Mérel
mesh_terms: D001007:Anxiety; D001294:Attitude to Health; D004644:Emotions; D006801:Humans; D008171:Lung Diseases / Q000523:psychology; D008175:Lung Neoplasms / Q000175:diagnosis / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D012649:Self Concept; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000517:prevention & control; D013315:Stress, Psychological; D014342:Truth Disclosure
keywords: Annonce diagnostique; Cancer; Diagnostic announcement; Post-traumatic stress disorder; Représentation sociale; Social representation; Stress post-traumatique; Trauma; Traumatisme