Structuration des processus de décision : Le cas de la transfusion sanguine française (1950-1985)

Abstract : This work is based on theoretical reflection about the way the decision and action processes are structured within organisations, and on an enquiry into the processes that led the French blood transfusion system to take a series of controversial decisions between 1983 and 1985. These decisions were responsible for multiple prosecutions ("French tainted blood scandal"). The theoretical work relies on the strategic analysis of organisations and on the strategic decision processes field; it uses the concept of the strategic paradigm of organisations. The empirical work is supported by an in-depth historical analysis of the French blood transfusion network since the end of the '40s, and of two of its partners: the Public Health Department and the French Haemophiliacs' Association. It includes a detailed analysis of the evolution of scientific knowledge in the field of blood transmissible infections, specifically viral hepatitis and AIDS. The results show that strategic paradigms, identified by historical analysis, were highly instrumental in the decision-making processes of 1983-1985. Within the blood banks network, the strategic, technical and financial independence of each blood bank represented a deep cultural value and a real operational constraint. The French Haemophiliacs' Association and its medical counsellors actively promoted a new therapeutic approach to haemophiliacs, claiming the increased risk of infection was a fallacy. The Health Department had been focusing on the search for a way of regulating an autonomous transfusion system that had proven impossible to control. Compared to a judicial approach and its search for individual failures, this research highlights the importance of the structural context which largely determines the actors' strategies, and illustrates the heuristic relevance of the strategic paradigm concept.
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François Mangin. Structuration des processus de décision : Le cas de la transfusion sanguine française (1950-1985). Gestion et management. HEC PARIS, 2004. Français. ⟨NNT : 2004EHEC0007⟩. ⟨pastel-00994786⟩

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