Formation initiale des sages-femmes en éthique médicale : autour du projet de naissance

An ethical approach to healthcare involves questioning clinical practices. The aim being to optimise patient care. Such an approach is far from easy and requires specific training, which has been included in numerous curricula for many years now. The role of medical ethics teaching in the curricula of midwives has never really been studied. This study proposes to assess its role, using the birth plan as an example, with the three fundamental values of care that it represents: patients' autonomy, vulnerability, and rights. It is a qualitative, retrospective study. The latter was conducted by interviewing midwife lecturers, and by questionnaire with 53 students from the 2010-2014 year group of two Parisian midwifery schools of the AP-HP (Assistance publique-Hôpitaux de Paris). The results show that medical ethics teaching has an important role in the training programme. However, abstract “life skills” notions, such as autonomy, are not clearly present in the curriculum. Addressed in a random fashion by the lecturers, the students have a poor grasp of such notions. This study proposes ideas for discussion to improve the quality of the humane treatment of patients, whilst preserving the essential safety of treatment. The participation of patient associations is one possible source of improvement.