Cette publication ne fait pas partie de la bibliothèque YouScribe
Elle est disponible uniquement à l'achat (la librairie de YouScribe)
Achetez pour : 14,25 €

Lecture en ligne (cet ouvrage ne se télécharge pas)

"Choking Game" and other Fainting Games

De
201 pages
The game that young people call the "choking game", which has been picked up on in the media and which the media helps to spread, is certainly not new. However, new communication channels have taken away the secrecy surrounding various practices that share the same aim of inducing cerebral hypoxia whilst they portrayed them as trivial or even harmless. Given that it may never be in our power to control the flood of information over the Internet, how can we convey full, objective information, which is still the best means of prevention against the pipe-dreams, manipulations and lark mirrors?
Voir plus Voir moins

APEAS
International Symposium
“Choking Game” and other Fainting Games
Practices, Consequences and Prevention

Françoise Cochet (ed.)
APEAS President

APEAS
International Symposium
“Choking Game” and other Fainting Games
Practices, Consequences and Prevention

L’HARMATTAN

© L’Harmattan, 2010 5-7, rue de l’Ecole-Polytechnique, 75005 Paris http://www.librairieharmattan.com diffusion.harmattan@wanadoo.fr harmattan1@wanadoo.fr ISBN : 978-2-296-12292-5 EAN : 9782296122925

APEAS International Symposium
“Choking Game” and other Fainting Games: Practices, Consequences and Prevention

INTRODUCTION ............................................................................ 13 FRANÇOISE COCHET ................................................................. 13 APEAS President DOMINIQUE DE PENANSTER ..................................................... 17 Promotion de la santé et prévention des maladies chroniques Direction Générale de la Santé JEAN-LOUIS NEMBRINI ............................................................. 21 Chief Director – Primary and Secondary Education INTRODUCTION ............................................................................ 26 JEAN-FRANÇOIS DEHECQ .......................................................... 26 Chairman of the Sanofi-Aventis Board of Directors JOCELYN LACHANCE................................................................. 30 PhD Student in Sociology, University of Strasbourg, Université Laval de Québec FAINTING AND SUFFOCATION PRACTICES IN CHILDREN: IMMEDIATE AND LONG-TERM CONSEQUENCES........................ 31 DR JEAN LAVAUD ..................................................................... 31 Doctor and Emergency Paediatrician

6

International Symposium, Paris the 3rd- 4th dec. 2009 - APEAS

THE CHOKING GAME AND ITS VARIANTS: A PHYSIOPATHOLOGICAL APPROACH TO RISKS IN TERMS OF MORTALITY AND SUBSEQUENT EFFECTS IN CHILDREN AND ADOLESCENTS .............................................................................. 35 DR FRÉDÉRIC JOYE ................................................................... 35 Director of Emergency Care Training Centre – Aude ASPHYXIAL GAMES OR “THE CHOKING GAME”: EVALUATION OF A POTENTIALLY FATAL RISK BEHAVIOUR ... 41 DR ANDREW MACNAB .............................................................. 41 Paediatrician, Professor at the University of British Columbia – Vancouver, Canada ASPHYXIAL GAMES IN CHILDREN AND YOUTH ......................... 46 DR THOMAS ANDREW............................................................... 46 Paediatrician, Forensic Scientist, Chief Medical Examiner – State of New Hampshire ON CONSTRICTION OF THE NECK AND ALTERED STATES OF CONSCIOUSNESS : WHAT THE MEDICAL LITERATURE TEACHES US ................................................................................. 50 ANNE CORREA GUEDES ............................................................ 50 Professor – Universidade Autonoma, Lisbon FROM LACK OF PREVENTION TO CHOKING GAME INCITEMENT. WHAT PRACTICES LAW MUST CONSIDER? ....... 60 MARIE-LAURE LAFFAIRE .......................................................... 60 Trial Lawyer, Paris Bar JEAN-MARIE HUET.................................................................... 64 Magistrate Director of Criminal Affairs and Pardons Ministry of Justice – Paris CHOOSING PUBLIC POLICIES TO PREVENT SUFFOCATION PRACTICES IN CHILDREN AND ADOLESCENTS .......................... 66 HAKIMA AIT EL CADI ............................................................... 66 Sociologist, Anthropologist, Specialist in Adolescence, Avignon GAMES, DANGERS AND RITES..................................................... 68 THIERRY GOGUEL D'ALLONDANS ............................................. 68 Educator, Anthropologist – University of Strasbourg

APEAS - International Symposium, Paris the 3rd- 4th dec. 2009

7

ANTHROPOLOGY OF VERTIGO AND FAINTING .......................... 70 DAVID LE BRETON .................................................................... 70 Professor of sociology and anthropology – University of Strasbourg DISCUSSION WITH THE AUDIENCE .............................................. 83 JOSÉ FERNANDEZ ...................................................................... 83 Chousingha Association Founder BREATHLESS ................................................................................ 89 DR JEAN-CLAUDE FISHER ......................................................... 89 Psychiatrist specialising in Adolescents Marseille IS THERE SUCH THING AS AN AT-RISK CHILD? THE VIEWPOINT OF A CHILD PSYCHIATRIST .................................... 93 DR MARIE-FRANCE LE HEUZEY ............................................... 93 Child and Adolescent Psychiatrist Robert Debré Hospital, Paris TO EACH AGE ITS FAINTING PRACTICE? .................................. 96 DR CHRISTOPHE RATHELOT ..................................................... 96 Child and Adolescent Psychiatrist – Edouard-Toulouse Hospital Complex, Marseille DISCUSSION WITH THE AUDIENCE ............................................ 102 HYPOXYPHILIA: THREE CASES INCLUDING A TWO-FOLD ONE ............................................................................................. 106 ANNE CORREA GUEDES .......................................................... 106 Professeur – Universidade Autonoma, Lisbonne INTERNATIONAL ROUND TABLE ............................................... 111 PRESENTATION OF THE NATIONAL ACTION BY THE VICTIMS DELEGATION .............................................................. 135 MARYVONNE CHAPALAIN ...................................................... 135 Retired Police Officer THE BPDJ’S PREVENTION EFFORTS: WORK WITH STUDENTS, STUDENT RESPONSE, TEACHER AND PARENT POSITIONS, AWARENESS-RAISING IN THE MILITARY POLICE ........................................................................................ 139

8

International Symposium, Paris the 3rd- 4th dec. 2009 - APEAS ALAIN BOUCHERIE .................................................................. 139 Captain, of Gard BPDJ HERVÉ ARREDONDO ............................................................... 144 Captain of the Pyrénées Orientales BPDJ

FAINTING GAMES: AN OVERVIEW OF AWARENESSRAISING EFFORTS ...................................................................... 147 SCOTT METHENY .................................................................... 147 Police Officer Specialised in Prevention, Willow Grove, Pennsylvania, United States DISCUSSION WITH THE AUDIENCE ............................................ 153 ROLE AND PLACE OF NATIONAL EDUCATION IN THE PREVENTION AND RECOGNITION OF THE CHOKING GAME AND ITS DERIVED FORMS .......................................................... 161 FRANÇOISE CUSIN ................................................................... 161 Technical Medical Advisor, Academic Inspectorate of Mâcon INFORMATION AND PREVENTION METHODS INSTITUTED IN VARIOUS COUNTRIES STRATEGIES AND AVENUES FOR EFFECTIVE ACTION AT NATIONAL AND INTERNATIONAL LEVELS ....................................................................................... 168 DR FRÉDÉRIC JOYE ................................................................. 168 Director of Emergency Care Training Centre – Aude CARRIE DRAHER ..................................................................... 173 Mother to Levi, Wichita, Kansas, USA, Author of the ED4ED Programme SHARRON GRANT .................................................................... 175 Mother of Jesse, President of the Association GASP, Ontario, Canada & KRISTEN GRANT ................................................................. 175 JOSE FERNANDEZ .................................................................... 177 Chousingha Association President JEAN-LUC DENNY ................................................................... 181 Head Educational Advisor and Trainer, Strasbourg Rectorate FRANÇOISE COCHET ............................................................... 183 APEAS President

APEAS - International Symposium, Paris the 3rd- 4th dec. 2009

9

DR CHARLY FAMPOU TOUNDJI ............................................... 187 Head of Public Health, Municipal Health Centre, Noisyle-Sec DISCUSSION WITH THE AUDIENCE ............................................ 191 CONFERENCE CLOSING ............................................................. 198 FRANÇOISE COCHET ............................................................... 198 APEAS President JOSÉ FERNANDEZ .................................................................... 200 President of Chousingha Association

Thursday, 3rd December 2009

Introduction
Françoise Cochet
APEAS President I think we will get started now, even though we are still awaiting a number of people, who are at the registration desk, because we do not want to get too far behind schedule. On behalf of Apeas Association, of which I am President, I would like to thank you for attending. I also thank all those who had planned to attend today and who were prevented from doing so, either by the flu or vaccine shot requirements. We have not had much luck, given the concurrence of this issue. In particular, I wish to thank Roselyne Bachelot-Narquin, Minister of Health and Sport, for having kindly agreed to host this event, and lent us this room and all of the equipment in it for these two days of our conference. She will be represented by Doctor Penanster, from the French National Health Directorate. I also thank Luc Chatel, Minister of Education, who was unable to make himself available over these two days, but who will be represented by the Director General of Primary and Secondary Education, Jean-Louis Nembrini. I wish to thank Marie-Dominique Simonet, Minister of Compulsory Education in the French-Speaking Community of Belgium, for her support. She will be represented by Etienne Jockir, Advisor to the PMS Centres. Patrick Gérard, Rector of the School Board and Chancellor of the Universities of Paris, whom I thank for his support, kindly sent Sylvie Gonnet, Technical Advisor to the Rector’s Office, to represent him. My sincerest gratitude goes to Jean-François Dehecq, Chairman of Sanofi-Aventis, who, for years now, since 2002, when upon being informed of our initiative, he immediately recognised it as the serious health issue that it is and the need to break the taboo on this form of children’s “play” – for, indeed, it is “play”, which

14 International Symposium, Paris the 3rd- 4th dec. 2009 - APEAS actually translates into practices that can turn out deadly or have disastrous consequences (i.e., permanent disabilities). These practices have been so widespread for dozens of years, yet ultimately only came under scrutiny in 2000, previously unknown to parents and professionals, meaning physicians or nurses, alike. Jean-François Dehecq recognised this as a public health issue before us and has unceasingly supporting us, helping us out and advising us. His sponsorship department at Sanofi-Aventis, present with us today, also deserves our sincerest thanks for its support, headed by Director Caty Forget, as well as the entire team at the department. I would also like to thank the French MPs present in the room or soon to arrive, in particular those from the UMP, who worked all summer on a report on this topic: Cécile Dumoulin, Member of Parliament representing the Yvelines and Patrice Verchère, MP representing the Rhône. As well, I thank the Belgian MPs and their representatives. On behalf of the association, I would like to express our profound gratitude to all of those who agreed to speak at this conference. Jean-Marie Huet, Judge and Director of Criminal Affairs and Pardons at the Ministry of Justice, kindly agreed to share with us how penal law considers these practices. He will join us later this morning. Professors Andrew MacNab and Thomas Andrew, who crossed oceans to be with us for these two days, will share their work and thoughts with us as well. Doctor Marie-France Le Heuzey, who agreed to come share her opinion, as a child and adolescent psychiatrist, as well as her conclusions. Dr Charly Fampou-Toundji and the city of Noisy-le-Sec, where he is public health coordinator, who will talk about his experience in prevention. Naturally, I think all of the members of our Scientific Committee, composed – you will hear each of them, so I will not mention them each by name – doctors, emergency doctors, paediatricians, sociologists specialised in risk behaviours, including one Professor from the University of Strasbourg,

APEAS - International Symposium, Paris the 3rd- 4th dec. 2009

15

psychiatrists, child psychiatrists, as well as one person who comes from Lisbon, who has carried out a great deal of research on the existing literature and will address a particularly thorny topic for us tonight. I also wish to thank the National Civil Police Force, the National Military Police Force, the United States Police Force, also represented today, the Ministry of the Interior’s victims’ delegation, which has launched a number of very important initiatives, precisely aimed at informing the civil police, the military police and also the fire-fighters. The Victims’ Delegation will be represented by Ms Chapalain, a police officer who retired this summer. I also thank the entire national education community. In addition to Mr Nembrini, it is represented in particular by Françoise Cusin, physician and technical advisor to the Saône-etLoire School Board, which has been partner to our association for many years. She will also speak tomorrow afternoon and her presentation of what her department has achieved will be very valuable to us. My sincerest gratitude goes to the families of the victims present and who will remain with us throughout these two days. Not all of the victims’ families are here, of course, as their large numbers would have more than filled this venue, Salle Laroque. These are families of victims and parents who have committed to carrying out information and prevention initiatives, or parents who are professionals themselves, for instance, in medicine or biology or nursing. I thank all of the parents who came from different continents, spending many hours in airplanes to join us and who will speak, tomorrow, about the initiatives underway in their countries and how they managed to break the taboo on this game that has taken so many lives. We learned of further deaths this week in France as well as abroad. I will conclude by addressing special thanks to the parents of victims who have come together in two associations, Chousingha and Gasp, and the Caljar Support Committee, several representatives of which are here today. Thanks to Cabu, for the drawing he gave us for this conference. Thanks to Davy Kilembe, who will sing us his “Indian Dream” song tomorrow.

16 International Symposium, Paris the 3rd- 4th dec. 2009 - APEAS As stated, we will start by setting out the issue. We will try to understand the why, the how, the causes and the consequences. Why are these practices so dangerous? How can we warn parents, of course, but also children – from the youngest to those at university – of the horrifying consequences of these practices, which they believe to be harmless, which they think are totally commonplace and which cause deaths, as I told you, every month in France and, as I stated, across the world. Thank you.

APEAS - International Symposium, Paris the 3rd- 4th dec. 2009 Dominique De Penanster Promotion de la santé et prévention des maladies chroniques Direction Générale de la Santé

17

Madame Françoise Cochet, Chairperson, Ladies and Gentlemen, I would first like to apologise on behalf of Roselyne BACHELOT, Minister of Health and Didier HOUSSIN, Chief medical officer in France, who are sorry that they are unable to open this conference but have been detained elsewhere in connection with the ongoing flu pandemic, as I'm sure you will understand. They have asked me to represent them and to assure you of the close attention with which they are following the topic that has brought us together for these two days. I am particularly pleased to welcome you to the Ministry of Health, to demonstrate the support of the French Department of Health and my department in particular for the work of the Association of Parents of Children Involved in Strangulation Accidents (Association de Parents d’Enfants Accidentés par Strangulation, Apeas), which has organised this event. Preventing risk behaviour in young people is one of the key aspects of the public health policy in this segment of the population which Roselyne Bachelot initiated in February 2008 in the Youth Health Plan. Every accident is a tragedy. And it is all the more so when a young person is involved and when the outcome is disability or death. But these causes of morbidity and mortality are avoidable and that is why the Ministry of Health undertook to fight against dangerous games two years ago, when you, Madame Cochet, came to present the problem to me at our first meeting. On that occasion, introducing your association to me, you said that: “Our only wish is that no one should experience the nightmare that we have been through, and that no another child or teenager should die because he or she took part in a foolish game, unaware of or under-estimating the danger involved”. We can only reiterate these words and make the battle that you are fighting our battle. Each year in France and in Europe, many children and teens become victims of hazardous games.

18 International Symposium, Paris the 3rd- 4th dec. 2009 - APEAS By engaging or taking part in them, voluntarily or otherwise, these young people are often unaware of the dangers involved or the disastrous consequences to which they expose themselves. Even though, accidents resulting from "scarf game (the most widely-known) and the work developed by the Apeas in reaching the authorities' and media's attention, has started to encourage discussions on this topic, families, healthcare professionals and professionals working in contact with young people are still largely unaware of the extent of the phenomenon of dangerous games and their consequences. Added to this, there is a heavy silence surrounding the phenomenon, both among the children and young people themselves and sometimes among official bodies, hence the limited amount of data about the actual frequency of such activities. When a tragic accident does occur, it is difficult to identify it as such, since dangerous play does not necessarily come to mind as the possible cause. This explains why epidemiological data on the topic are scarce and scattered, coming from a variety of sources which cannot easily be compared in order to establish reliable national statistics. These sources include the Ministry of Education, hospital emergency rooms, the French emergency services, the civil police, military police, local authorities, associations like Apeas and others still. It is estimated that 15 to 20 young people die each year in France as a result of engaging in these games. These figures probably under-represent the reality, since some accidents are considered to be suicides by hanging or strangulation, or even the accidental outcome of traditional games. It is therefore very difficult to establish trends and ideas are needed as to how data can be gathered more effectively, so as to obtain a better understanding of this phenomenon and thereby add to the studies that have been carried out in France and internationally. These dangerous games are played by children and teenagers within the family circle as well as in the school environment, and are spread in particular by the Internet, where certain sites promote such games without any warning about the hazards involved. Several types of games exist, and are categorised as intentional or forced (meaning that the child takes part in the game

APEAS - International Symposium, Paris the 3rd- 4th dec. 2009

19

unwillingly), but may also vary in how they are carried out and in the circumstances surrounding them. A distinction is made between the following, under a wide variety of names: games of assault, in which gratuitous physical violence is used by a group against a child chosen as a target or scapegoat throughout an entire day, based on a pretence determined in the morning (e.g., clothing of a certain colour, their birthday, etc.) games of oxygendeprivation, choking, suffocation or fainting, to which the “scarf game” belongs, and which are some of the oldest. This category of play, which is the focus of this conference, consists of obstructing breathing, thus slowing oxygen flow to the brain and creating anoxia, in order to experience intense sensations or pseudohallucinatory visions, sometimes heightened by attempting to hyperventilate, leading to loss of consciousness, coma and, in some cases, death. The risk of death is even higher when the young person repeats the game alone at home. This two-day event will focus on oxygen-deprivation or fainting games. My offices also address games of assault, in view of their impact on the young people's health and the violence they represent. As well as gaining a better grasp of this devastating trend, it is important that we fight it and, in this respect, the best weapon is prevention. Prevention means spreading information about the risks associated with such activities to the general public and healthcare professionals, who need to be aware of certain symptoms that young people may display (signs on the skin of the neck, buzzing in the ears, headache, withdrawal, etc.), as well as to professionals working in contact with young people, especially those in the State education system. When targeting information at young people, special care must be taken in determining the quantity, angle and educational impact of the messages, so as not to produce the opposite effect from the one sought and instead put ideas into young people’s heads. Madame Cochet, I am aware of the many conferences, discussions and information and prevention sessions you hold with young people and know that you will fight unfailingly to prevent families from experiencing tragedies like these. Dissemination of the materials you have developed to prevent young people from taking part in fainting games is vital for professionals in the fields

20 International Symposium, Paris the 3rd- 4th dec. 2009 - APEAS of healthcare and education. They help them work effectively with children and contribute to bucking the trend and, ultimately wiping it out, in line with the target you have set out. For this reason, over these last two years, the Ministry of Health and Sport has provided its support to Apeas, so that there can be more prevention initiatives and so that healthcare and education professionals can be informed of and trained in the prevention methods that can be used to prevent such tragedies. Our work also completes the work being done by the Ministry of Education and more specially, the Directorate General for Primary and Secondary Education, which has also been involved, for many years in action to prevent violence, one example of which is the brochure, “Dangerous Games and Violent Practices”, available at the Eduscol Web site. The presence of the officials from the Ministry of Education and National Police Force at this conference, as well as the address by the Director General of Primary and Secondary Education scheduled for tomorrow show that all of the relevant Ministries are now mobilised to fight this serious problem in our society. You stated that these two days should broach the topic of dangerous games, exploring even their most complex aspects.The agenda shows a wide range of presentations which will surely contribute to an extremely productive exchange, particularly through experience-sharing with the foreign representatives expected tomorrow. I will unfortunately not be able to be here with you for both days, but will keep a keen ear to the conference conclusions. We will meet again to officially set up other initiatives, of which this conference is only the start. I wish you all a successful conference, one that allows you to make your contribution to fighting this trend affecting our children and young people and to which no one could be indifferent, whether they are a parent or not.