O presente trabalho de Dissertação visa a realizar um levantamento bibliográfico de relatos sobre a frequência do uso da Simulação como um instrumento ou meio para a obtenção de algum ganho secundário, durante a realização de exames médicos com as mais diversas finalidades, tais como o clínico, ambulatorial, de emergência, ocupacional, pericial, previdenciário, securitário ou demandas judiciais. Quais são os ganhos secundários nas mais diversas especialidades e também repercussões em termos interpessoais, empresariais, ocupacionais e de custo para o sistema de saúde como um todo. A repercussão no Direito da Simulação utilizada em Medicina. / This thesis work aims to conduct a literature review of reports on the frequency of the use of simulation as a tool or means to obtain some secondary gain during medical examinations with many different purposes, such as clinical outpatient, emergency, occupational, forensic, social security, insurance or lawsuits. What are the secondary gains in various specialties and also repercussions in terms interpersonal, business, occupational and cost to the health system as a whole. A Law repercussions in the Simulation used in Medicine.

Swedish Obesity Specialists examines how obesity is conceptualized as a medical condition by the staff working at an obesity clinic in Stockholm Sweden. Through eight weeks of participant observations and eight semi-structured interviews this thesis answers the question of how specialist working in the field of obesity construct obesity as a medical site. The thesis aims at understanding how obesity is becoming an issue for medicine, further how obesity’s entry into medicine creates new understandings of the body and medical treatments. Through the theoretical concepts of global assemblages and bio-power I argue that obesity as a disease is defined through seemingly objective criteria aimed at defining a population of sufferers, simultaneously for obesity to be viewed as disease scientifically valid treatments on an individual level must be put into place. By viewing obesity’s entry into medicine as a process of shared consensus, this thesis examines the relationship between global levels of knowledge production and their application and negotiation at one clinic treating obesity. Here expert knowledge and governance are integrated to create both treatment and an idea of what obesity as a medical condition is. In this thesis I argue that the application of expert knowledge and global criteria leads to unexpected views on what can be conceived as medical treatment. Further the thesis discusses how the body of the patient becomes reinterpreted once obesity becomes a medical condition.

Submitted by Rosina Valeria Lanzellotti Mattiussi Teixeira (rosina.teixeira@unisantos.br) on 2015-05-08T12:52:28Z No. of bitstreams: 1 Selda H. C. DO N. PEREIRA.pdf: 1275038 bytes, checksum: 395189327b5154728676096b650eb44b (MD5) / Made available in DSpace on 2015-05-08T12:52:28Z (GMT). No. of bitstreams: 1 Selda H. C. DO N. PEREIRA.pdf: 1275038 bytes, checksum: 395189327b5154728676096b650eb44b (MD5) Previous issue date: 2015-03-30 / BACKGROUND: Burnout Syndrome affects many types of professions, being more common in those that require greater contact with customers, especially teachers and health professionals. Several studies have been conducted in Brazil and worldwide about this condition, potentially linked to work. OBJECTIVES: To evaluate the prevalence of Burnout Syndrome in Medical Experts of the Social Security in the Executive Management of Campina Grande - PB. METHODS: Had been done a cross-sectional study with the application of questionnaires MBI (Maslach Burnout Inventory) to check the syndrome and a questionnaire of socio-demographic informations with questions about age, gender, title, shift work, work experience and time hours working week. Currently, according to the Executive Management of the National Social Security Institute - INSS of Campina Grande -. Pb, this population is made up of 39 experts. Based on this information was included the entire population of experts who were in work activity for at least 12 consecutive months and agreed to participate voluntarily in the study. Experts were excluded if they were away from their activities for vacation, leave, hospitalization. This research was based on guidelines and regulatory standards for research, established in the Resolution of the National Health Council (NHC) No. 466/12, in force in the country. A descriptive analysis was performed of all variables, comparison tests between two percentages, Pearson's correlation coefficient. The significance level was 5%. RESULTS: There was a slight predominance of females. A higher prevalence of married experts (comparison test between two percentages, p <0.001), with children (comparison test between two percentages, p <0.001), and with Medical Specialization (comparison test between two percentages, p <0.001) . It was observed that more than 80% of professionals are in danger of developing burnout (comparison test between two percentages p <0.001). CONCLUSION: Much needs to be done to improve the working conditions of the expert and minimize the problems of the working relationship between experts, peers, INSS and insured. The present work, it is not proposed to examine this relationship, however these types of conflicts between experts, policyholders and the own institution, affect the worker's relationship with his work. / INTRODUÇÃO: A Síndrome de Burnout acomete muitos tipos de profissões, sendo mais comum naquelas que exigem um maior contato com os clientes, especialmente professores e profissionais da área de saúde. Vários estudos têm sido conduzidos no Brasil e no mundo inteiro à cerca dessa patologia, potencialmente ligada ao trabalho. OBJETIVOS: Avaliar a prevalência da Síndrome de Burnout em Médicos Peritos da Previdência Social na Gerência Executiva de Campina Grande ¿ PB. MÉTODOS: Foi realizado um estudo transversal com a aplicação dos questionários MBI (Maslach Burnout Inventory) para verificar a síndrome e um questionário de dados sócio-demográficos com questões a respeito de idade, sexo, titulação, turnos de trabalho, tempo de experiência profissional e carga horária de trabalho semanal. Atualmente, segundo dados da Gerência Executiva do Instituto Nacional de Previdência Social ¿ INSS de Campina Grande ¿ PB, essa população é formada por 39 peritos. Baseado nessa informação foi incluída toda a população de peritos que estavam em atividade laboral há pelo menos 12 meses consecutivos e aceitaram participar voluntariamente da pesquisa. Foram excluídos os peritos que estavam afastados de suas atividades por férias, licença, hospitalização. Foi realizada a análise descritiva de todas as variáveis, testes de comparação entre duas porcentagens e coeficiente de correlação de Pearson. O Nível de significância foi de 5%. RESULTADOS: Houve um ligeiro predomínio do sexo feminino. Uma maior prevalência de peritos casados (teste de comparação entre duas porcentagens, p<0,001), com filhos (teste de comparação entre duas porcentagens, p<0,001), e com Especialização Médica (teste de comparação entre duas porcentagens, p<0,001). Observou-se que mais de 80% dos profissionais estão em risco de desenvolvimento da síndrome de burnout (teste de comparação entre duas porcentagens com p <0, 001). CONCLUSÃO: Muito precisa ser feito no sentido de melhorar as condições de trabalho do perito e minimizar os problemas da relação de trabalho entre peritos, pares, INSS e segurados. O presente trabalho, não se propôs analisar essa relação, porém esses tipos de conflitos entre peritos, segurados e a própria instituição, afetam a relação do trabalhador com o seu trabalho.

A perícia médica se constitui em uma avaliação pela qual devem passar todos os que solicitam determinados benefícios previdenciários, como o auxílio-doença, e o Benefício de Prestação Continuada (BPC), vinculado à assistência social. As conclusões dos médicos peritos, emitidas através de um laudo pericial, envolvem decisões quanto a existência ou não de “(in)capacidade para o trabalho” e deficiência, e podem ser determinantes para a concessão ou o indeferimento do auxílio-doença, por exemplo, e do BPC. Quando as decisões são contrárias à concessão, ou seja, quando não há o reconhecimento da incapacidade ou deficiência, tentativas de reverter estas decisões na justiça tem se constituído em uma alternativa, com destaque para a atuação da Defensoria Pública da União (DPU). A exigência da perícia e seus critérios de avaliação tem suscitado diversos debates públicos, conflitos e controvérsias que tornam explícitas moralidades diversas. A partir do trabalho de campo realizado na DPU, nos espaços de debates em torno da prática de perícia, como congressos, e com as pessoas envolvidas no processo pericial (sobretudo, as que solicitam benefícios, médicos e profissionais do campo jurídico), esta tese busca reunir diferentes discursos, concepções e embates em torno da perícia médica previdenciária, demonstrando que há uma disputa em relação a definição de categorias e competências. Também destaca o quanto determinados conceitos, como os de doença, (in)capacidade e (in)validez, deficiência, e mesmo de trabalho e cidadania, acabam sendo constituídos e atualizados, na prática, por moralidades que partem não só dos médicos peritos, mas das próprias pessoas que solicitam esses benefícios, em associação com instituições do judiciário, como a defensoria pública. Em um contexto de distribuição seletiva de direitos, o trabalho retrata um cenário de conflitos e disputas relacionados à própria prática da perícia si, à necessidade desta, suas decisões e implicações. / The medical expertise constitutes an evaluation which the requesters of certain social security benefits must undertake, such as sickness allowance and the Continuous Cash Benefit (BPC), linked to social assistance in Brazil. The findings of the medical experts, emitted through an expert report, involve decisions as to whether or not the worker has "(in)capacity for work" and/or disability, and can be decisive for the granting or refusal of the sickness allowance and the BPC, for example. When decisions are contrary to the concession, i.e. when there is no recognition of disability or impairment, attempts to reverse these decisions in court has been constituted as an alternative, especially through the Public Defender of the Union (DPU). The requirement for expertise and its evaluation criteria has raised several public debates, conflicts and controversies that make explicit different moralities. From my fieldwork in the DPU, in spaces of debate around the practice of medical expertise, such as congresses, and the people involved in the expert process (especially those applying for benefits, and medical professionals in the legal field), this thesis seeks to bring together various speeches, ideas and conflicts around the social security medical expertise to demonstrate that there is a dispute regarding the definition of categories and competences regarding the social security medical expertise. In that sense, certain concepts – such as disease, (in)ability and (in)validity, disability, and even work and citizenship – end up being informed and updated in daily practices by various moralities, not only from medical experts, but from the requesters of the benefits themselves, and also of the judicial institutions such as the Public Defender. In a context of selective distribution of rights, the work portrays a scene of conflicts and disputes related to very practice of medical expertise itself, its necessity, decisions and implications.

A perícia médica se constitui em uma avaliação pela qual devem passar todos os que solicitam determinados benefícios previdenciários, como o auxílio-doença, e o Benefício de Prestação Continuada (BPC), vinculado à assistência social. As conclusões dos médicos peritos, emitidas através de um laudo pericial, envolvem decisões quanto a existência ou não de “(in)capacidade para o trabalho” e deficiência, e podem ser determinantes para a concessão ou o indeferimento do auxílio-doença, por exemplo, e do BPC. Quando as decisões são contrárias à concessão, ou seja, quando não há o reconhecimento da incapacidade ou deficiência, tentativas de reverter estas decisões na justiça tem se constituído em uma alternativa, com destaque para a atuação da Defensoria Pública da União (DPU). A exigência da perícia e seus critérios de avaliação tem suscitado diversos debates públicos, conflitos e controvérsias que tornam explícitas moralidades diversas. A partir do trabalho de campo realizado na DPU, nos espaços de debates em torno da prática de perícia, como congressos, e com as pessoas envolvidas no processo pericial (sobretudo, as que solicitam benefícios, médicos e profissionais do campo jurídico), esta tese busca reunir diferentes discursos, concepções e embates em torno da perícia médica previdenciária, demonstrando que há uma disputa em relação a definição de categorias e competências. Também destaca o quanto determinados conceitos, como os de doença, (in)capacidade e (in)validez, deficiência, e mesmo de trabalho e cidadania, acabam sendo constituídos e atualizados, na prática, por moralidades que partem não só dos médicos peritos, mas das próprias pessoas que solicitam esses benefícios, em associação com instituições do judiciário, como a defensoria pública. Em um contexto de distribuição seletiva de direitos, o trabalho retrata um cenário de conflitos e disputas relacionados à própria prática da perícia si, à necessidade desta, suas decisões e implicações. / The medical expertise constitutes an evaluation which the requesters of certain social security benefits must undertake, such as sickness allowance and the Continuous Cash Benefit (BPC), linked to social assistance in Brazil. The findings of the medical experts, emitted through an expert report, involve decisions as to whether or not the worker has "(in)capacity for work" and/or disability, and can be decisive for the granting or refusal of the sickness allowance and the BPC, for example. When decisions are contrary to the concession, i.e. when there is no recognition of disability or impairment, attempts to reverse these decisions in court has been constituted as an alternative, especially through the Public Defender of the Union (DPU). The requirement for expertise and its evaluation criteria has raised several public debates, conflicts and controversies that make explicit different moralities. From my fieldwork in the DPU, in spaces of debate around the practice of medical expertise, such as congresses, and the people involved in the expert process (especially those applying for benefits, and medical professionals in the legal field), this thesis seeks to bring together various speeches, ideas and conflicts around the social security medical expertise to demonstrate that there is a dispute regarding the definition of categories and competences regarding the social security medical expertise. In that sense, certain concepts – such as disease, (in)ability and (in)validity, disability, and even work and citizenship – end up being informed and updated in daily practices by various moralities, not only from medical experts, but from the requesters of the benefits themselves, and also of the judicial institutions such as the Public Defender. In a context of selective distribution of rights, the work portrays a scene of conflicts and disputes related to very practice of medical expertise itself, its necessity, decisions and implications.

A perícia médica se constitui em uma avaliação pela qual devem passar todos os que solicitam determinados benefícios previdenciários, como o auxílio-doença, e o Benefício de Prestação Continuada (BPC), vinculado à assistência social. As conclusões dos médicos peritos, emitidas através de um laudo pericial, envolvem decisões quanto a existência ou não de “(in)capacidade para o trabalho” e deficiência, e podem ser determinantes para a concessão ou o indeferimento do auxílio-doença, por exemplo, e do BPC. Quando as decisões são contrárias à concessão, ou seja, quando não há o reconhecimento da incapacidade ou deficiência, tentativas de reverter estas decisões na justiça tem se constituído em uma alternativa, com destaque para a atuação da Defensoria Pública da União (DPU). A exigência da perícia e seus critérios de avaliação tem suscitado diversos debates públicos, conflitos e controvérsias que tornam explícitas moralidades diversas. A partir do trabalho de campo realizado na DPU, nos espaços de debates em torno da prática de perícia, como congressos, e com as pessoas envolvidas no processo pericial (sobretudo, as que solicitam benefícios, médicos e profissionais do campo jurídico), esta tese busca reunir diferentes discursos, concepções e embates em torno da perícia médica previdenciária, demonstrando que há uma disputa em relação a definição de categorias e competências. Também destaca o quanto determinados conceitos, como os de doença, (in)capacidade e (in)validez, deficiência, e mesmo de trabalho e cidadania, acabam sendo constituídos e atualizados, na prática, por moralidades que partem não só dos médicos peritos, mas das próprias pessoas que solicitam esses benefícios, em associação com instituições do judiciário, como a defensoria pública. Em um contexto de distribuição seletiva de direitos, o trabalho retrata um cenário de conflitos e disputas relacionados à própria prática da perícia si, à necessidade desta, suas decisões e implicações. / The medical expertise constitutes an evaluation which the requesters of certain social security benefits must undertake, such as sickness allowance and the Continuous Cash Benefit (BPC), linked to social assistance in Brazil. The findings of the medical experts, emitted through an expert report, involve decisions as to whether or not the worker has "(in)capacity for work" and/or disability, and can be decisive for the granting or refusal of the sickness allowance and the BPC, for example. When decisions are contrary to the concession, i.e. when there is no recognition of disability or impairment, attempts to reverse these decisions in court has been constituted as an alternative, especially through the Public Defender of the Union (DPU). The requirement for expertise and its evaluation criteria has raised several public debates, conflicts and controversies that make explicit different moralities. From my fieldwork in the DPU, in spaces of debate around the practice of medical expertise, such as congresses, and the people involved in the expert process (especially those applying for benefits, and medical professionals in the legal field), this thesis seeks to bring together various speeches, ideas and conflicts around the social security medical expertise to demonstrate that there is a dispute regarding the definition of categories and competences regarding the social security medical expertise. In that sense, certain concepts – such as disease, (in)ability and (in)validity, disability, and even work and citizenship – end up being informed and updated in daily practices by various moralities, not only from medical experts, but from the requesters of the benefits themselves, and also of the judicial institutions such as the Public Defender. In a context of selective distribution of rights, the work portrays a scene of conflicts and disputes related to very practice of medical expertise itself, its necessity, decisions and implications.

Dans un contexte de contrôle accru de l’immigration irrégulière et de la gestion serrée des frontières, de quelle manière, selon quelles modalités, par quelles directives et selon quelles applications, l’enfermement des étrangers en instance d’éloignement du territoire français, participe-t-il à la préparation de cette expulsion ?Cette thèse s’intéresse à la gestion de l’enfermement des étrangers dans un centre de rétention administrative (CRA), selon deux aspects centraux, la surveillance et le soin, et elle se focalise, à travers des pratiques de police et de santé, sur le rôle de cet enfermement dans la mise en œuvre de l’expulsion. Elle s’inscrit dans les travaux d’anthropologie de l’Etat et de la police et dans ceux de la sociologie de l’immigration et des lieux d’enfermement.Elle montre comment différentes formes de directives, propres à l’enfermement des étrangers, trouvent leur incarnation dans des agents dont les pratiques sont la résultante à la fois d’applications directes de ces directives et surtout de leurs aménagements, propres à la gestion des contradictions, découlant de ce lieu.Cette thèse s’intéresse d’abord aux pratiques de police fixées autour de la surveillance qui, dans le cadre de la gestion de certaines contradictions, propres à la rétention, devient, par glissement, un travail d’attente et d’anticipation, sous des formes allant de l’expectative à la recherche d’informations jusqu’aux stratégies locales de contrainte et de conditionnement. Elle se focalise ensuite sur les pratiques de santé, en montrant combien les enjeux de l’enfermement et de l’expulsion viennent à les façonner, de manière profonde, au point qu’elles soient parties prenant d’un processus de sélection et de différenciation. Elle s’intéresse enfin, dans ce travail global de préparation, aux effets des rapports entre la police et les professionnels de santé, dans cette gestion d’une population enfermée, tenue par la menace d’une expulsion. Cette thèse restitue, en somme, différentes pratiques, différents positionnements politiques et moraux, d’agents travaillant dans un dispositif de contrôle, administré par l’Etat, confrontés dans leur travail à des contradictions et à des conflits moraux.Ce travail est le fruit d’une enquête ethnographique mené au sein d’un CRA et d’entretiens et d’observations ciblés auprès d’acteurs appartenant à des lieux dont le CRA est dépendant. / In the wings of the deportation from french territory, between surveillance and assistance : Ethnographic exploration in a French Immigration Detention CentreIn a context of increasing control of irregular immigration and the tight management of borders, in what manner, according to what terms, by which directives and which applications, does the incarceration of foreigners pending to be expulsed from French territory participate in the preparation of this expulsion? This thesis deals with the management of the confinement of foreigners in a French Immigration Detention Centre, according to two central aspects, monitoring and care, and she focuses, through the practices of police and health, on the role of this imprisonment in the implementation of expulsion. It fits in the anthropology of the State and the police work and in those of the sociology of immigration and of the places of confinement. It shows how different forms of directives, specific to the confinement of foreigners, are embodied in agents whose practices are the result both of direct applications of these guidelines and especially their facilities, specific to the management of contradictions, arising from this place. This thesis focuses first on police practices fixed around surveillance which, under the management of contradictions, proper to the retention, becomes by a shift to a job of expectation and anticipation, in forms ranging from expectantly looking for information to local strategies of constraint and conditioning. It then focuses on the practices of health, by showing how the confinement and deportation issues come to shape them, in a profound way, to the point that they are involved in the process of selection and differentiation. Finally she deals with this comprehensive preparatory work, to the effects of the relationship between the police and health professionals, in the management of an incarcerated population, held by the threat of expulsion. This thesis renders, in sum, different practices, and different political and moral positions of the agents that are working in a control system, administered by the State, that are faced in their work to contradictions and moral conflicts. This work is the fruit of an ethnographic investigation conducted within a French Immigration Detention Centre and targeted interviews and observations with actors belonging to places on which the French Immigration Detention Centre is dependent.

La confrontation des soldats marocains avec la violence est un phénomène qui s’inscrit dans le temps. Elle a pris des formes multiples alors que les soldats marocains combattaient sous le drapeau français et les questions liées aux traumatismes de guerre sont devenues assez récemment un réel enjeu de société. Or de ce point de vue les soldats marocains sous domination française (protectorat) offrent un terrain d’enquête jusqu’à présent peu traité au Maroc et en France. Pourtant, de 1914 à 1954, ces soldats marocains, notamment très présents en Indochine, ont subi les conséquences de l’expérience de la violence de guerre sur leur psyché. Nous avons cherché à saisir et interpréter leur comportement en insistant sur la période de l’après Deuxième Guerre Mondiale.Pour comprendre les tensions vécues en Indochine par les combattants marocains, il fut nécessaire de situer tout d’abord le combattant dans sa conjoncture socioculturelle et dans la série des expériences militaires vécues avant la guerre d’Indochine (Grande Guerre et la Seconde Guerre mondiale) sur la base des sources d’archives (militaires, diplomatiques, médicales) et de l’évaluation des approches psychiatriques et médicales de l’époque. Pour l’après-1945 le travail est enrichi par une collecte triple (témoignages, récits de vie, et sémiologie post-traumatique) auprès de quelques anciens combattants. Ainsi l’impact psychologique lié à violence de guerre sur quarante ans d’expérience au sein de l’armée d’Afrique (1914-1954) a pu être cerné de façon nouvelle puisqu’une partie des observations permises par la confrontation à des anciens combattants a une portée certaine pour l’époque antérieure à leur engagement.Tout ce qui relève de pathologies psychologiques ou psychiatriques, notamment durant la guerre d’Indochine, a été analysé et a permis de réévaluer les voies suivies par ces soldats, qui vont jusqu’à la désertion et le passage à l’ennemi vietnamien ou encore des coups de folie meurtriers ou suicidaires, et d’éclairer le rapport au politique de ces hommes pris entre des causes qui n’étaient pas les leurs. Pour le cas de l’Indochine, certains d’entre eux ont vécu cette guerre comme l’expérience d’un lieu d’affirmations idéologiques. L’exil du roi Mohamed V les amena parfois à rejoindre la résistance indochinoise. D’autres soldats, faits prisonniers par le Viet-Minh, ont été bouleversés par l’expérience de la captivité.Cette thèse éclaire ainsi le rapport à l’engagement dans l’armée coloniale, le rapport aux violences subies et données, et offre une interprétation des comportements constatés qui montre le fonctionnement discontinu du rapport au religieux, l’impact des traumas sur la capacité de remémoration et de tissage des rapports sociaux après les guerres. Ceci éclaire sous un nouvel angle les sources d’archive disponibles sur ces soldats marocains de l’Armée d’Afrique et la façon dont les violences ont pesé sur eux. Cette recherche amène à penser que la mise à l’écart des dimensions traumatiques — au profit de l’héroïsme le plus souvent — dans les décennies qui ont suivi l’ère du protectorat a produit un effacement qui a faussé en partie la perception de l’histoire vécue par ces combattants / The confrontation of the Moroccan soldiers with violence is a phenomenon that inscribes itself in the time. It took many forms as Moroccan soldiers fought under the French flag, and issues related to war trauma became a real social issue quite recently. From this point of view, Moroccan soldiers under French rule (protectorate) offer a field of investigation hitherto little treated in Morocco and France. However, from 1914 to 1954, these Moroccan soldiers, particularly present in Indochina, suffered from the consequences of the experience of war violence on their psyche. We sought to interpret their behaviour.To understand the tensions experienced in Indochina by the Moroccan fighters, it was necessary to first, locate the fighter in his socio-cultural situation and in the series of military experiences lived before the Indochina war (Great War and World War II) based on archival sources (military, diplomatic, medical) and the evaluation of psychiatric and medical approaches of the time. For post-1945, work is enriched by a triple collection (testimonials, life stories, and post-traumatic semiology) with some veterans. Thus, the psychological impact linked to wartime violence over forty years of experience in the African army (1914-1954) could be identified in a new way.All that pertains to psychological or psychiatric pathologies, especially during the Indochina war, was analysed and allowed to re-evaluate the tracks followed by these soldiers, who go as far as desertion and the passage to the Vietnamese enemy or murderous or suicidal feats of madness, and to enlighten the relation to politics of these men caught between causes which were not theirs. In the case of Indochina, some of them experienced this war as the experience of a place of ideological affirmations. The exile of King Mohamed V sometimes led them to join the Indochinese resistance. Other soldiers, taken prisoner by the Viet-Minh, were upset by the experience of captivity.This thesis emphasises the relation to the commitment in the colonial army, the relation to the violence suffered and given, and offers an interpretation of the observed behaviours, which shows the discontinuous functioning of the relation with the religious, the impact of the traumas on the ability to remembrance and weaving of social relationships after wars. This sheds new light on the available archive sources of these Moroccan soldiers of the Army of Africa and the way the violence has weighed on them. This research suggests that sidelining this dimension in the decades following the protectorate era has produced an erosion that has partially distorted the perception of the story of these fighters

Le retrait du Mediator®, médicament des Laboratoires Servier en vente de 1976 à 2009, s’effectue après l’identification de pathologies spécifiques des valves cardiaques : les valvulopathies médicamenteuses. Depuis, l’évènement est abordé sous l’angle du scandale médico-sanitaire, des défaillances du système de régulation et des méthodes d’influence d’un industriel sur des décideurs (politiques ou prescripteurs). Une procédure juridique pour établir des probables infractions aux lois pénales est en cours. Pour comprendre les origines et les conséquences de l’affaire du benfluorex – au-delà des champs de compétence juridiques et politiques – ce travail de thèse propose une analyse du processus de non-reconnaissance d’un effet indésirable grave d’un médicament pendant plus de 30 ans et surtout les effets de ce non-repérage sur ceux qui sont directement concernés : les personnes l’ayant consommé. À partir des données issues de deux enquêtes par questionnaire distinctes adressées l’une à des usagers du Mediator® et l’autre à des cardiologues notre travail établit six différentes « figures » théoriques et analytiques des personnes exposées à la molécule se trouvant au centre de notre enquête. / The withdrawal of Mediator®, a drug sold by Laboratoires Servier between 1976 and 2009, occurred after specific pathologies of cardiac valves were identified: the drug induced valvular heart disease. Since then, the incident has been approached from the angle of health and medical scandal, regulation failure and the influence of an industrial company on decision makers (political figures or prescribers). A legal procedure to establish probable violations of criminal laws is under way. To understand the origins and consequences of the benfluorex affair - beyond the fields of legal and political jurisdiction - this thesis proposes an analysis of the process of non-recognition of a serious adverse side effect of a drug for over 30 years and, above all, the effects of this non-recognition on those directly concerned: the people having taken it. Using data from two separate surveys, one of Mediator® users and the other of French cardiologists, this study establishes six different theoretical and analytical "figures" of people exposed to the molecule at the center of the investigation.