Divergences de points de vue et conceptions de l'autonomie : le cas de Monsieur S.

The case reported is that of a 62-year old man with a chronic giant thoracic and abdominal aneurysm responsible for an acute respiratory insufficiency who was hospitalized against his will by his distressed wife and who died in the intensive care unit twelve days later. The ethical approach of Mr. S.'s case aims at reconstructing the two divergent positions expressed by his wife about his care that the medical team had to consider. The goal of all the parties was to achieve moral validity as well as respect the patient's autonomy. In the Anglo-Saxon philosophy, autonomy means acting according to one's wishes within the boundaries of laws, while according to Kant, it means eliminating internal or external causes that could justify a choice by anything other than an act of free will that can be universalized. Moreover, the patient being no longer conscious, his decision could not change with time, be-it in the dialectic movement of thought, or in the inter-subjective relationship inherent to this type of existential choice. The medical intervention aimed at allowing the patient to express his wishes for a last time, and his wife's sincerity in communicating her husband's wishes, attempted to maintain the possibility of choice for as long as possible, which represents the proof of a moral stance.