Laïcité, médecine, éthique et politiques publiques (XIXe-XXIe siècle)

This article provides an overview of the relationship between the medical institution, ethics and public policies in France, from 1789 to our days, in a perspective of historical sociology of political secularism (or laicity). Three thresholds of laicization must be distinguished. The first threshold is one where religion always serves as a foundation for public morality, but also where medicine gradually becomes a moral activity by itself. It is in an ascending phase. There are many conflicts between medical ethics and religious morality (from the end of the eighteenth to the end of the nineteenth). The second threshold marks the establishment of medicine, which becomes the moral institution of society, where religion and its moral value are privatized and must acclimatize to the requirements of the medical institution. The power of the physician replaces the power of the priest as a moral character (end of the nineteenth-1970s). With the third threshold, the ethical questioning gradually applies to medicine itself. The « rights of the sick » constitutes a new moral requirement that culminates in the right to « die in dignity » and the consideration of moral requirements of the patient. Bioethics is born in this context. Despite resistances, the medical institution adapts itself to this new situation (1970-…).