Est-ce qu’il souffre ? Enjeux éthiques de l’introduction d’un dispositif d’hétéroévaluation du confort en fin de vie

Abstract

Avoiding suffering for patients at the end of life is a central objective of the palliative care, which engages caregivers on a daily basis at the bedside of patients and their families. However, there are many limits to this objective, linked to the definition of suffering, to the difficulty of assessing the suffering of others, and finally to the solutions available for its management. In an attempt to unravel some of these issues, we address the challenges of assessing suffering in palliative care, through self-evaluation, hetero-evaluation and physiological measurements. We present a technical tool designed for pain monitoring in intensive care anesthesia. The ethical issues raised by the extension of its use to the palliative care relate to its validation, to what the tool does or does not show, and to the question of setting its threshold. It's a question of rethinking the place left to technique in the work of care in palliative care, and the way in which we construct support with it. We will open up perspectives by outlining the role that palliative care research can play in exploring these issues.