O assentamento Viamão, localizado no município de mesmo nome, foi o local escolhido para compreender as estratégias de ascensão social de determinados grupos de assentados. Partimos da hipótese de que o espaço de mediação entre o INCRA e os assentamentos está permeado de relações do tipo patrão-cliente, o que possibilita o controle dos recursos públicos por parte do segmento dos assentados que dirigem ou estão vinculados ao MST e, com isso, promovem a ascensão de uma elite política nos assentamentos, com os correlatos prejuízos por parte daqueles que não se enquadram às novas hierarquias. Para dar conta desta tarefa, acompanhamos o desenrolar das ações dos mediadores e as disputas internas pelo controle dos recursos públicos (terra, água para irrigação do arroz, recursos financeiros e até a possibilidade de definição daqueles que devem ser ou não punidos pelo INCRA, órgãos de controle e justiça) entre as duas principais facções internas. Para além das vicissitudes típicas de assentamentos brasileiros, este contou com algumas peculiaridades – grande presença de várzeas, ausência de demarcação por logo período e limitações relacionadas à presença de reservas ambientais – que conformaram uma fraca institucionalização interna e contribuíram para engendrar modos de vida adaptativos. O principal deles foi representado por uma combinação de pluriatividade com arrendamento das várzeas para plantio do arroz por outros assentados. Este processo foi viabilizado por coalizões informais, na forma de conjuntos-ação com elementos de relação patrão-cliente. Constatamos que o grupo ligado ao MST, com ideário socializante e, fundamentalmente, ecologizante, obteve êxito no domínio do espaço de mediação, inclusive pela expulsão daqueles que o opunham. Isto foi possível graças a uma cadeia clientelística que começava nos conjuntos-ação, passava por brokers internos ao assentamento e alcançava as “panelinhas” existentes no INCRA, momento em que o processo se apresenta como uma espécie de clientelismo concentrado, na medida em que somente os líderes do MST conseguem construir pontes entre o buraco estrutural que separa o INCRA dos assentados e consolidar uma doxa legitimadora do discurso militante, causa e conseqüência deste processo. / Viamão The settlement, located in the municipality of the same name, was the venue for understanding the strategies for social mobility of certain groups of settlers. Our hypothesis is that the area of mediation between INCRA and the settlements is permeated by relations of patron-client, which enables control of public resources by the segment of the settlers who run or linked to the MST and thus, promote the rise of a political elite in the settlements, with the related losses by those who do not fit the new hierarchies. To cope with this task, we follow the progress of the actions of mediators and the infighting for control of public resources (land, water for irrigation of rice, funds and even the possibility of defining those who should be punished or not by INCRA, organs control and justice) between the two main internal factions. In addition to the vicissitudes of typical Brazilian settlements, it had some peculiarities - the large presence of wetlands, lack of demarcation for long period and limitations related to the presence of environmental reserves - which have made a weak internal institutionalization and helped engender adaptive lifestyles. The main one was represented by a combination of pluriativity with tenancy of the paddy fields for planting rice by other settlers. This process was made possible by informal coalitions in the form of jointaction with elements of patron-client relationship. We find that a group linked to the MST, with socialist and, essentially, ecological ideals succeeded in the area of mediation, including the expulsion of those who opposed. This was possible thanks to a chain that began in clientelistic joint-action, passed by the internal settlement brokers and reached the "panelinhas" of INCRA bureaucracy, when the process is presented as a sort of clientelism concentrated, in that only MST leaders can build bridges between the structural hole that separates the INCRA of the settlements and consolidate a discourse militant legitimating doxa, cause and consequence of this process.

O assentamento Viamão, localizado no município de mesmo nome, foi o local escolhido para compreender as estratégias de ascensão social de determinados grupos de assentados. Partimos da hipótese de que o espaço de mediação entre o INCRA e os assentamentos está permeado de relações do tipo patrão-cliente, o que possibilita o controle dos recursos públicos por parte do segmento dos assentados que dirigem ou estão vinculados ao MST e, com isso, promovem a ascensão de uma elite política nos assentamentos, com os correlatos prejuízos por parte daqueles que não se enquadram às novas hierarquias. Para dar conta desta tarefa, acompanhamos o desenrolar das ações dos mediadores e as disputas internas pelo controle dos recursos públicos (terra, água para irrigação do arroz, recursos financeiros e até a possibilidade de definição daqueles que devem ser ou não punidos pelo INCRA, órgãos de controle e justiça) entre as duas principais facções internas. Para além das vicissitudes típicas de assentamentos brasileiros, este contou com algumas peculiaridades – grande presença de várzeas, ausência de demarcação por logo período e limitações relacionadas à presença de reservas ambientais – que conformaram uma fraca institucionalização interna e contribuíram para engendrar modos de vida adaptativos. O principal deles foi representado por uma combinação de pluriatividade com arrendamento das várzeas para plantio do arroz por outros assentados. Este processo foi viabilizado por coalizões informais, na forma de conjuntos-ação com elementos de relação patrão-cliente. Constatamos que o grupo ligado ao MST, com ideário socializante e, fundamentalmente, ecologizante, obteve êxito no domínio do espaço de mediação, inclusive pela expulsão daqueles que o opunham. Isto foi possível graças a uma cadeia clientelística que começava nos conjuntos-ação, passava por brokers internos ao assentamento e alcançava as “panelinhas” existentes no INCRA, momento em que o processo se apresenta como uma espécie de clientelismo concentrado, na medida em que somente os líderes do MST conseguem construir pontes entre o buraco estrutural que separa o INCRA dos assentados e consolidar uma doxa legitimadora do discurso militante, causa e conseqüência deste processo. / Viamão The settlement, located in the municipality of the same name, was the venue for understanding the strategies for social mobility of certain groups of settlers. Our hypothesis is that the area of mediation between INCRA and the settlements is permeated by relations of patron-client, which enables control of public resources by the segment of the settlers who run or linked to the MST and thus, promote the rise of a political elite in the settlements, with the related losses by those who do not fit the new hierarchies. To cope with this task, we follow the progress of the actions of mediators and the infighting for control of public resources (land, water for irrigation of rice, funds and even the possibility of defining those who should be punished or not by INCRA, organs control and justice) between the two main internal factions. In addition to the vicissitudes of typical Brazilian settlements, it had some peculiarities - the large presence of wetlands, lack of demarcation for long period and limitations related to the presence of environmental reserves - which have made a weak internal institutionalization and helped engender adaptive lifestyles. The main one was represented by a combination of pluriativity with tenancy of the paddy fields for planting rice by other settlers. This process was made possible by informal coalitions in the form of jointaction with elements of patron-client relationship. We find that a group linked to the MST, with socialist and, essentially, ecological ideals succeeded in the area of mediation, including the expulsion of those who opposed. This was possible thanks to a chain that began in clientelistic joint-action, passed by the internal settlement brokers and reached the "panelinhas" of INCRA bureaucracy, when the process is presented as a sort of clientelism concentrated, in that only MST leaders can build bridges between the structural hole that separates the INCRA of the settlements and consolidate a discourse militant legitimating doxa, cause and consequence of this process.

O assentamento Viamão, localizado no município de mesmo nome, foi o local escolhido para compreender as estratégias de ascensão social de determinados grupos de assentados. Partimos da hipótese de que o espaço de mediação entre o INCRA e os assentamentos está permeado de relações do tipo patrão-cliente, o que possibilita o controle dos recursos públicos por parte do segmento dos assentados que dirigem ou estão vinculados ao MST e, com isso, promovem a ascensão de uma elite política nos assentamentos, com os correlatos prejuízos por parte daqueles que não se enquadram às novas hierarquias. Para dar conta desta tarefa, acompanhamos o desenrolar das ações dos mediadores e as disputas internas pelo controle dos recursos públicos (terra, água para irrigação do arroz, recursos financeiros e até a possibilidade de definição daqueles que devem ser ou não punidos pelo INCRA, órgãos de controle e justiça) entre as duas principais facções internas. Para além das vicissitudes típicas de assentamentos brasileiros, este contou com algumas peculiaridades – grande presença de várzeas, ausência de demarcação por logo período e limitações relacionadas à presença de reservas ambientais – que conformaram uma fraca institucionalização interna e contribuíram para engendrar modos de vida adaptativos. O principal deles foi representado por uma combinação de pluriatividade com arrendamento das várzeas para plantio do arroz por outros assentados. Este processo foi viabilizado por coalizões informais, na forma de conjuntos-ação com elementos de relação patrão-cliente. Constatamos que o grupo ligado ao MST, com ideário socializante e, fundamentalmente, ecologizante, obteve êxito no domínio do espaço de mediação, inclusive pela expulsão daqueles que o opunham. Isto foi possível graças a uma cadeia clientelística que começava nos conjuntos-ação, passava por brokers internos ao assentamento e alcançava as “panelinhas” existentes no INCRA, momento em que o processo se apresenta como uma espécie de clientelismo concentrado, na medida em que somente os líderes do MST conseguem construir pontes entre o buraco estrutural que separa o INCRA dos assentados e consolidar uma doxa legitimadora do discurso militante, causa e conseqüência deste processo. / Viamão The settlement, located in the municipality of the same name, was the venue for understanding the strategies for social mobility of certain groups of settlers. Our hypothesis is that the area of mediation between INCRA and the settlements is permeated by relations of patron-client, which enables control of public resources by the segment of the settlers who run or linked to the MST and thus, promote the rise of a political elite in the settlements, with the related losses by those who do not fit the new hierarchies. To cope with this task, we follow the progress of the actions of mediators and the infighting for control of public resources (land, water for irrigation of rice, funds and even the possibility of defining those who should be punished or not by INCRA, organs control and justice) between the two main internal factions. In addition to the vicissitudes of typical Brazilian settlements, it had some peculiarities - the large presence of wetlands, lack of demarcation for long period and limitations related to the presence of environmental reserves - which have made a weak internal institutionalization and helped engender adaptive lifestyles. The main one was represented by a combination of pluriativity with tenancy of the paddy fields for planting rice by other settlers. This process was made possible by informal coalitions in the form of jointaction with elements of patron-client relationship. We find that a group linked to the MST, with socialist and, essentially, ecological ideals succeeded in the area of mediation, including the expulsion of those who opposed. This was possible thanks to a chain that began in clientelistic joint-action, passed by the internal settlement brokers and reached the "panelinhas" of INCRA bureaucracy, when the process is presented as a sort of clientelism concentrated, in that only MST leaders can build bridges between the structural hole that separates the INCRA of the settlements and consolidate a discourse militant legitimating doxa, cause and consequence of this process.

Sammanfattning   Datum: 7 juni 2020   Nivå: Kandidatuppsats i företagsekonomi, 15 hp   Akademi: Akademin för Ekonomi, Samhälle och Teknik (EST), Mälardalens högskola   Författare:  Abdelkarim Arisha           Stefan Dragosavljevic           Daniella Varli                        (97/08/19)                            (95/05/05)                (98/10/08)   Titel: Digitaliseringens påverkan på relationen mellan revisor och klient - En analys av           tidigare forskning   Handledare: Esbjörn Segelod   Forskningsfråga: Hur har digitaliseringen påverkat revisorns sätt att arbeta och vilka        konsekvenser har det medfört på relationen mellan revisor och klient?                                  Syfte: Syftet med denna litteraturstudie är att utifrån existerande studier och forskningar            granska och analysera hur revisorns arbetssätt har påverkats i samband med            digitaliseringen och vilka konsekvenser det medfört för revisorernas relation till sina            klienter. Vidare studeras om det uppkommit nya faktorer som revisorn måste anpassa sig till. Metod: Denna litteraturstudie har genomförts med en kvalitativ metod. Sekundärdata i form   av vetenskapliga artiklar som är peer-reviewed, uppsatser skrivna av tidigare   studenter, böcker och webbplatser insamlades till studien.   Slutsats: Pappersarbetet har minskat då revisorernas arbete har digitaliserats vilket har     effektiviserat revisorns vardagliga arbete och revisorn har nu mer tid till att vara     tillgänglig för sina klienter. Digitaliseringen har resulterat i att den fysiska kontakten     mellan revisorn och klienten har minskat eftersom de numera använder sig av     digitala hjälpmedel som mail för att kommunicera med varandra. Konsekvenserna     är att relationen inte blir lika personlig mellan parterna som kan leda till att de     långsiktiga relationerna kan komma att bli begränsade. I studien har det     framkommit att kommunikationen är grundstenen för en lyckad relation mellan     revisorn och klient.   Nyckelord: Digitalisering, revisor, klientrelation, kommunikation, långsiktiga relationer, oberoende, förtroende. / Abstract   Date: June 7th, 2020   Level: Bachelor thesis in Business Administration, 15 cr   Institution: School of Business, Society and Engineering, Mälardalen University   Authors:     Abdelkarim Arisha            Stefan Dragosavljevic            Daniella Varli                         (97/08/19)                           (95/05/05)                  (98/10/08)   Title: The effect of digitalization on the relationship between auditor and client - An analysis           of previous research   Tutor: Esbjörn Segelod   Research: How has the digitalization affected the auditor’s way of working and what       consequences has this had on the relationship between auditor and client?                            Purpose: The purpose of this literature study is to examine and analyze, based on existing      studies and research, how the auditor's working methods have been affected in      connection with digitalisation and the consequences this has had for the auditors'      relationship with their clients. Furthermore, it is studied whether there are new      factors that the auditor must adapt to.   Method: This literature study was conducted using a qualitative method. Secondary data such as peer-reviewed scientific articles, essays written by other authors, books and websites were collected for the study.   Conclusion:  The paperwork has decreased as the auditors' work has become digital, which            has streamlined the auditor's everyday work and the auditor now has more time            to be available to his clients. The digitization has resulted in a reduction in the            physical contact between the auditor and the client as they now use digital tools            such as e-mail to communicate with each other. The consequence is that the            relationship does not become as personal between the parties, which can lead            to the long-term relationships becoming limited. The study found that            communication is the cornerstone of a successful relationship between the            auditor and the client.   Keywords: Digitalization, auditor, client relationship, communication, long-term         relationship, independence, trust.

I Sverige avskaffades den obligatoriska revisionen för småföretag den första november 2010. Till följd av detta beslut blev svenska små aktiebolag ej revisionspliktiga. Trots slopandet av revisionsplikten har många småföretag valt att frivilligt anlita en revisor. Därför blir det intressant att undersöka faktorer som kan påverka efterfrågan på frivillig revision i svenska småföretag. Studien syftar till att få svar på följande frågan: Vilka faktorer påverkar efterfrågan på frivillig revision hos små aktiebolag i Sverige? För att kunna besvara frågan har insamling av empiriska materialet skett genom en kvantitativ metod i form av en webbenkät. Totalt har 44 fullständiga svar erhållits. Med hjälp av Independent Sample Test har studiens fyra hypoteser testats. Resultatet indikerar på att företagsledare önskan att förbättra kvalitet på finansiella rapporter och önskan att förbättra relationer med kreditgivare och skattemyndigheten är de faktorer som påverkar efterfrågan på frivillig revision hos svenska små aktiebolag. Dock har denna studie inte hittat ett samband mellan frivillig revision och företagsstorlek mätt i nettoomsättning, antal anställda, och balansomslutning. Resultatet indikerar även på att det inte finns något samband mellan delägare utan tillgång till finansiella information och frivillig revision. Studien har bidragit med att undersöka en del av faktorer som kan ha påverkan på efterfrågan på frivillig revision hos småföretag i Sverige. Resultat från denna studie kan vara till nytta för revisionsbyråer för att förstå företagsledare inställning gentemot revision. / In Sweden, the mandatory audit for small companies was abolished on November 1, 2010. As a result of this decision, many of the small Swedish companies were not required to be audited. Despite the abolition of the audit obligation, many small companies have chosen to hire an auditor voluntarily. Therefore, it will be interesting to investigate the factors that affect the demand for voluntary auditing in small Swedish companies. The study aims to answer the following question: What factors influence the demand for voluntary auditing at small Swedish companies? The obtaining of empirical material has been done through a quantitative method in a form of a questionnaire sent to respondents. A total of 44 complete responses were obtained. Using the Independent Sample test, the study's four hypotheses were tested. The results indicate that business leaders' desire to improve the quality of financial reports and the desire to improve relations with creditors and the tax authority are the factors that affect the demand for voluntary audits at small Swedish companies. However, this study has not found a relationship between the voluntary auditing and company size measured in turnover, number of employees, and total assets. The result also indicates that there is no connection between shareholders without access to financial information and voluntary auditing. The study has contributed to investigate certain factors that may affect voluntary auditing in small companies in Sweden. Results from this study could be of benefit for audit firms to understand business leaders' attitudes toward auditing.

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During the Covid-19 pandemic, employees all over the world were forced to work from home, meaning that consultants no longer could work physically present with their clients. As the consultant-client relationship is incredibly important for management consulting firms, it is interesting to investigate how these relationships have been impacted by the change and what the implications are for collaboration and performance. A qualitative method was used, where the authors conducted interviews with management consultants at an international management consulting firm in Stockholm, Sweden. The study found that remote working with already existing clients was functioning well. However, collaboration with new relations proved to be more challenging, which was mainly perceived to depend on the difficulty to create a personal trust and connection remotely, since digital communication made it difficult to understand the client’s needs. The digital way of working also revealed challenges with creativity, invisibility, onboarding, knowledge development and sales. Thus, the study concluded that collaborations and relationships will benefit greatly from a physical meeting early on. Nevertheless, the most beneficial working method would be to continuously balance the advantages of both remote and office working. / Under Covid-19-pandemin tvingades anställda över hela världen att arbeta hemifrån, vilket innebar att konsulter inte längre kunde arbeta på plats hos sina kunder. Då kundrelationer är extremt viktiga för konsultföretag är det intressant att undersöka hur dessa relationer har påverkats av distansarbetet och vilka konsekvenser det har fört med sig för samarbetet och arbetskvalitet. För att undersöka detta användes en kvalitativ metod där författarna genomförde intervjuer med managementkonsulter på ett internationellt konsultföretag i Stockholm, Sverige. Studien visade att distansarbete med redan existerande kunder i allmänhet fungerade bra. Däremot visade sig samarbetet med nya kontakter vara mer utmanande. Detta ansågs främst bero på svårigheten att skapa ett personligt förtroende och en personlig relation på distans, då digital kommunikation försvårade möjligheterna att förstå sig på kunden och dess behov. Det digitala arbetssättet skapade också nya utmaningar vad gäller kreativitet, osynlighet, integrering av nyanställda, kunskapsutveckling samt försäljning. Slutligen, studien visade att samarbeten och relationer skulle främjas av att parterna träffas fysiskt i ett tidigt skede av projektet. Dock skulle den mest fördelaktiga arbetsmetoden vara att framöver balansera fördelarna av både distans- och kontorsarbete.

Prior research has shown that there are many factors affecting the client's perception of the auditor’s value. Furthermore, research has shown that the auditor can add multifaceted value to the client, often divided into core value and added-value. However, these factors have mostly been studied in an isolated context, where other factors have not been accounted for. To our knowledge no prior study has shown the combined effect of various factors in a common context, as well as showing how the conjunction between the client’s experiences and expectations affects the perceived value of the auditor from the client’s perspective. This study aims to identify the many factors that drive the client's perception of value added by the auditor, as well as making the distinction between the client's experiences and expectations. In order to locate the many factors that are believed to have an impact on the client's perception of the auditor’s value, a broad theoretical model is constructed to explain how these factors in a combined fashion drives the client's perception of auditor value. We also argue that the client's internal and underlying conditions will affect the client’s attitude towards the auditor, as well as inducing the client's needs. Furthermore, we make the distinction between the factors that drive the precepted value of the auditor and the factors that make up value in the eyes of the client.   The results of the study indicate that there are many factors that affect the perceived value of the auditor from the client’s perspective, where the client’s experiences and expectations of the “client quality” has the strongest effect on the perceived value. The study also finds that there is a gap between the client’s expectations and experiences, suggesting that there could be an expectation gap between the client and the auditor. Furthermore, the study finds that the core value is the main type of value added by the auditor in the eyes of the client. However, we argue that the distinction between core value and added-value is not representative from the client’s perspective. Instead we believe that the client distinguishes the value added by the different activities in the work of the auditor.  The study contributes towards explaining how various factors need to be accounted for when studying the perceived value of the auditor from the client's perspective. Furthermore, the study contributes to explaining how the client's experiences and expectations affect the perceived value of the auditor in the eyes of the client, providing a meaningful foundation for future research. The study also contributes to explaining how there needs to be a distinction between the factors that drive the perceived value and the factors that make up the perceived value, since these factors often intervene with one another. / Tidigare forskning har visat att det finns många faktorer som föranleder klientens syn på revisorns värde. Vidare har tidigare forskning visat att revisorn kan tillföra ett mångfacetterat värde till klienten, ofta uppdelat i kärnvärde och mervärde. Dock har dessa påverkande faktorer främst studerats i en isolerad miljö där andra påverkande faktorer inte har tagits hänsyn till. Såvitt vi vet har ingen tidigare studie visat den kombinerade effekten av olika faktorer i en gemensam kontext, samtidigt som förhållandet mellan klientens upplevelser och förväntningar tas i beaktning.  Denna studie syftar till att identifiera de faktorer som föranleder klientens syn på revisorns värde, samtidigt som det görs skillnad på klientens upplevelser och förväntningar. För att lokalisera de flertalet faktorer som tros ha en inverkan på klientens syn på revisorns värde konstrueras en utförlig teoretisk modell för att förklara hur dessa faktorer gemensamt föranleder och utgör värde ur klientens perspektiv. Vi hävdar även att klientens interna och underliggande förutsättningar påverkar klientens inställning till revisorn, liksom att dessa förutsättningar föranleder klientens olika behov. Dessutom gör vi en distinktion mellan de faktorer som föranleder det värde klienten ser i revisorn och de faktorer som utgör värdet av revisorn ur klientens perspektiv. Resultatet av studien indikerar att det finns många faktorer som påverkar revisorns värde ur ett klientperspektiv, där klientens upplevelser och förväntningar på ”klientkvalitet” har störst effekt på det samlade värde klienten ser i revisorn. Studien finner också att det finns en skillnad mellan klienternas upplevelser och förväntningar, vilket tyder på att det kan finnas ett förväntansgap mellan klienten och revisorn. Vidare visar studien att kärnvärdet är den typ av värde klienten främst ser i revisorns arbete. Vi hävdar dock att skillnaden mellan kärnvärde och mervärde inte är representativt ur klientens perspektiv. Istället tror vi att klienten baserar synen på revisorns värde utifrån de olika aktiviteter och attribut som hänförs till revisorns arbete.  Studien bidrar till att förklara hur flera olika faktorer behöver tas i beaktning när man studerar revisorns tillförda värde ur klientens perspektiv. Vidare bidrar studien till att förklara hur klientens upplevelser och förväntningar påverkar det värde klienten ser i revisorn, vilket utgör en stark grund för framtida forskning. Studien bidrar också till att förklara hur det är nödvändigt att göra skillnad mellan de faktorer som föranleder värde och de faktorer som utgör värde ur klientens perspektiv, eftersom dessa faktorer ofta samspelar med varandra.

This qualitative study focuses on digitalisation in the social-work field within an ethical context. As a result of society's digital development and after the covid-19 pandemic paralyzed the world, today many meetings between professionals and clients take place through digital services. The purpose of this study is mainly to examine the role of digital meetings in the social-worker-client relationship. Through interviews with professionals working with digital tools in the field of social work, this study has been able to show both the opportunities and the challenges of digitalisation for the relationship between social worker and client.

Un phénomène de résistance au traitement pharmacologique chez les personnes souffrant de maladies psychiatriques graves et persistantes comme la schizophrénie, tel que révélé par la pratique des soins psychiatriques communautaires de première ligne, sert de point de départ pour poser une distinction fondamentale entre les notions de traitement et de soins. Conséquemment, la question du consentement selon qu’il est attribué au traitement ou aux soins suggère des formes de consentement distinctes susceptible d’affecter la façon de faire face à des problèmes particuliers sur le plan de l’éthique. L’analyse conceptuelle d’un certain modèle d’interventions psychiatriques de crise, qui regroupe des travailleurs de la santé et des policiers au sein d’une même équipe de travail, permet de circonscrire des catégories de problèmes éthiques qui conduiront éventuellement à la formalisation d’une approche de résolution de problème. Trois façons d’approcher un problème d’éthique clinique sont proposées sous la forme d’enjeux, de dilemmes, puis de défis éthiques. L’intervention de crise y est catégorisée selon quatre niveaux d’intensité de crise, donnant lieu à une appréciation subjective par le soignant de la capacité de la personne soignée d’établir et de maintenir une relation de soins en situation de crise. Des parallèles entre les soins psychiatriques et les soins palliatifs permettent d’approfondir la question de la souffrance en lien avec la douleur et de distinguer à nouveau les notions de soins et de traitement. La relation de soins est présentée comme une occasion de normaliser les rapports entre soignants et soignés, de valoriser un état de souffrance à l’origine de la rencontre de soins, tout en mettant à profit la dimension relationnelle d’une condition qui appelle à être non pas traitée mais soignée. Ces considérations permettent de dégager une responsabilité nouvelle pour le soignant : celle de se faire le gardien de la relation de soins. Une transition du primum non nocere au primum non excludere : d’abord ne pas exclure est suggérée comme une maxime pour guider la relation de soins vers un consentement aux soins plus authentique. / Resistance to or non-compliance with medical interventions on the part of people presenting with severe and persistent manifestations of a psychiatric disorder, such as schizophrenia, will be the context in which to develop a formal distinction between the concepts of treatment and care, and subsequently between the consent to treatment and consent to care as separate forms of consent. The practice of first line community psychiatry will serve as a starting point to raise interesting challenges from an ethical standpoint. This thesis will explore the ethical implications of consent within a therapeutic relationship. Discussion around a specific model of crisis intervention characterized by a multidisciplinary approach will lead to the categorization of ethical problems and the formalization of a problem-solving model. A three-fold approach to ethical problems will be presented in terms of issues, dilemmas and ethical challenges. Crisis intervention will be categorized into four increasing levels of intensity based on the subjective assessment of a person in crisis and their capacity to establish and maintain a therapeutic rapport with a caregiver, throughout and beyond the crisis. Parallels between psychiatric and palliative care will be established in order to question the concepts of suffering and pain and to stress the importance of setting distinctions, once again, between care and treatment. The rapport that can develop between a caregiver and a person cared for will be presented as an opportunity to normalize a specific therapeutic rapport and value a perceived state of suffering calling for change, a condition that requires not treatment, but rather caring. These considerations will lead to the identification of a new goal for the caregiver, that is, to preserve the therapeutic rapport. A transition from the primum non nocere to a primum non excludere, i.e., “first, do not exclude “will serve as a motto to provide guidance towards a more authentic consent to care.