« Démontage » de dispositifs techniques médicaux en soins palliatifs : singularité et dynamique subjective

The admission of a patient in palliative care puts the whole system of representations of each concerned person at work and it also induces the mobilization of the interactions and the roles they play. In this article, the authors propose to focus on the effect of the disassembling of medical technical devices which takes place for certain patients at the entry in a unit of palliative care (for example at the moment of leaving an intensive care unit) and also on the function of the psychologist in this situation. This action causes a rupture having a direct impact on the coordinates, which constitute the reality of the patient and his family. In addition, the frequent emergence of primitive anguishes and fears is a consequence of the reissue of an archaic state of distress. In the case of the disassembling of the medical technical devices, the reality of the body is the object of the action, but this has necessarily an effect on the symbolic representation and the imaginary consistency of subjectivity. The function of the psychologist could be inscribed thus in a space of elaboration which restores the possibility of creation of a new world where the subject, by the ethical dimension of the act, can continue to exist.