Psychogenic non epileptic seizures (PNES) are clinical events of psychological nature. Video-electroencephalography monitoring (V-EEGM) is a valuable method for the diagnosis of PNES and may be combined with provocative tests to induce seizures. The use of placebo in provocative tests for the diagnosis of PNES is controversial because of associated deception, and contrasts with the use of truly decreasing epileptogenic threshold techniques such as hyperventilation and photo stimulation. We present a clinical case of a pregnant woman with a past history (...) of refractory epilepsy, admitted in the obstetric department due to unremitting seizures. In this clinical context, non-deceiving provocative tests such as hyperventilation and photo stimulation could be potentially harmful, nevertheless, the use of intravenous saline injection presented as a safer alternative to diagnose PNES and hence obviate an urgent caesarean. This case illustrates a disproportionate risk of causing harm when telling the truth, in comparison with the benefit of avoiding such risk, although deceiving the patient. This is a clinical example of how considerations concerning the use of placebo must be evaluated in an individual basis. (shrink)

La machine uniformisatrice de la mondialisation prétend respecter la diversité des langues et des cultures, qui est devenue l'un des nouveaux dogmes de ce temple socioculturel universel qu'est l'Unesco. Mais elle manque encore de profondeur et d'originalité dans sa manière de concevoir et de consolider cette diversité ; une profondeur et une originalité que l'on peut, par contre, découvrir dans les basses couches de la société mondiale, riches de leurs particularismes identitaires, fécondes par leurs métissages et innovantes grâce aux bouleversements (...) constants qu'elles subissent. Cette réflexion part de l'étude de quelques textes fondamentaux de l'Unesco qui donnent des orientations en vue de la sauvegarde et de l'optimisation de la diversité culturelle et linguistique du monde actuel. Elle est un regard critique porté sur les incohérences dans la démarche vers une démocratisation culturelle universelle.Standardizing the machine of globalization claims to respect the diversity of languages ​​and cultures, which became one of the dogmas of the new temple universal sociocultural what Unesco. But it still lacks depth and originality in its thinking and consolidate this diversity depth and originality that can, by cons, discovered in the lower layers of the global society, rich of their specific identity , productive and innovative by their interbreeding with the constant changes they undergo. This reflection on the study of some fundamental texts of Unesco which provide guidance for safeguarding and optimizing the cultural and linguistic diversity in the world today. It is a critical look focused on inconsistencies in the approach to a universal cultural democratization. (shrink)