Apport du psychologue lors d'une prise de décision médicale difficile

When confronted with a complex situation, the practitioner's decision is based on a rational process taking into consideration the rigorous objectivity of medicobiological data, but also involves a “blind” area where the logic of the subconscious plays a role. In the context we are examining, this unclear area is the motor which will symbolically lead the practitioner's thinking to the right decision, i.e. the decision which comes closest to the patient's desires. Today, multidisciplinary discussions are the ultimate tool allowing practitioners to achieve the most appropriate conclusions. These exchanges have the capacity to disclose the subconscious processes and the phantasms of each individual participant. In this context, the psychologist can use the psychoanalytical method to invite the participants to consider seriously their own words and their symbolic efficacy. Through a better understandings of the coordinates of the psychic life of the caregiver, it is possible to discover the role played by the phantasmagoric directly issuing from the clinical encounter and thus disclose the essence of the patient's subjective truth, using the patient's own system of values, history and desires. Thus, this method enables thinking beyond the medicobiological reality to risk a deconstruction of the signification and go beyond the disorder of language to reach an ethic form of truth seen as the effect of expression.