Risque et existence : un éclairage du risque thérapeutique en psychiatrie

Risk management is a principle of political action, an organisational strength that keeps increasing in our modern societies. In medicine, the benefit/risk ratio precedes any therapeutic treatment. Psychiatry also confirms this trend. It is undoubtedly desirable in many aspects. However, the notion of risk cannot be understood under the unique and technical perspective of an undesirable event to anticipate. Risk management is not limited to a predictive and preventive refinement, but disturbs the situation of the individual in its environment, granting him a new responsibility, changing his possibility to live in the world and take shelter in it. Beyond these anthropological aspects, from a phenomenological psychiatry perspective, the matter of risk is closely related to the question of authentic existence. Thus, the risk not only appears under the perspective of an undesirable event, but also as a founding instant of the existence in the world and within oneself. Therefore, the therapeutic project of psychiatry could also intend to recognize and promote a certain type of risk, the risk of any existential commitment. The therapeutic risk in psychiatry thus takes a new ontological dimension.