Amour et haine en fin de vie

Care for the dying - attempting to relieve their suffering, accompanying them in their last moments - is a manifestation of love, widely considered as the heart of palliative care. This is a world where everything possible is done to remedy the excesses of medical technicity, so patients and their families can have a haven of peace for dying. From this imagery, the healthcare worker becomes a “charitable” person, providing care when all hope is lost. The dying patient also becomes a disincarnated asexual being with no past or future, and no desires other than the search for an answer to the final enigma. But have we forgotten that death is meaningless for the eminently living subconscious? This is why we have chosen to focus on an obscure part of our daily practice, exposing the other fascinating and idealized side of palliative care: the antechamber to paradise, and hell. Without denying the imperative need for personal assistance in our individualized society, the need for loving and caring, must we deny the reality of the hatred that is also part of dying? Must we blind ourselves to its violent expression? But hate can be incongruent, masked by a caregiver's excessive devoutness or hidden under the cover of extreme sacrifice, family guilt, or even the morbid sadness of the dying. These obscure forces incite us to be wary of “palliative” altruism, of our desire to “reconcile” the patient with death. From these forces spring forth the crucial ethical issue of self-assessment.