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Abstract
À partir d’un séminaire destiné aux étudiants en médecine intitulé Soignants face à la mort et de nos propres travaux en ethnographie hospitalière et dans le champ de la psychiatrie de liaison dans un hôpital général, nous discutons le statut des émotions dans les soins. Interrogés sur la fin de vie par nos groupes d’étudiants, les soignants décrivent souvent les émotions comme dangereuses et l’importance de s’en prémunir comme primordiale. À partir de ce constat et d’une certaine ambivalence décrite par les étudiants, nous revenons sur la place des émotions dans la littérature biomédicale et en sciences sociales. Les émotions suscitant l’intérêt des sciences sociales sont surtout celles des patients et les décisions cliniques sont le plus souvent envisagées comme étant contraintes par des valeurs et des normes imposées aux soignants, eux-mêmes sans émotion apparente. Cette posture redouble ainsi curieusement l’idée, répandue dans les soins et plus généralement dans nos sociétés, selon laquelle les émotions risquent de mettre à mal la capacité à penser de manière rationnelle et objective et doivent être mises à l’écart. Or, en sciences sociales et notamment en ethnographie, les émotions des chercheurs sont perçues comme de fidèles indicateurs ; de même, dans les soins, les travaux du psychanalyste Michael Balint insistent sur la nécessité d’une prise en compte par les cliniciens des émotions suscitées par les patients. Sur cette base, il serait pertinent de redonner aux émotions une place centrale pour guider les actions des chercheurs comme des cliniciens.
Based on a seminar for medical students entitled Caregivers Facing Death and from our own work in hospital ethnography and liaison psychiatry at the general hospital, we discuss the status of emotions in care. When asked by students about their experience with end-of-life, caregivers often describe emotions as dangerous, and the importance of protecting oneself from them as paramount. Based on this observation, we return to the place of emotions in the biomedical and social sciences literature. Emotions of interest to the social sciences are mainly those of patients, and clinical decisions are most often seen as constrained by values and norms imposed on caregivers, themselves without apparent emotion. This posture curiously reinforces the idea, widespread in health care and more generally in our societies, that emotions can impair the ability to think rationally and objectively and must be put aside. In ethnography, however, researchers’ emotions are seen as reliable indicators; similarly, the work of psychoanalyst Michael Balint emphasizes the need for clinicians to take into account the emotions of patients. On this basis, it would be possible to restore emotions to a central role in guiding the actions of researchers and clinicians alike.
Based on a seminar for medical students entitled Caregivers Facing Death and from our own work in hospital ethnography and liaison psychiatry at the general hospital, we discuss the status of emotions in care. When asked by students about their experience with end-of-life, caregivers often describe emotions as dangerous, and the importance of protecting oneself from them as paramount. Based on this observation, we return to the place of emotions in the biomedical and social sciences literature. Emotions of interest to the social sciences are mainly those of patients, and clinical decisions are most often seen as constrained by values and norms imposed on caregivers, themselves without apparent emotion. This posture curiously reinforces the idea, widespread in health care and more generally in our societies, that emotions can impair the ability to think rationally and objectively and must be put aside. In ethnography, however, researchers’ emotions are seen as reliable indicators; similarly, the work of psychoanalyst Michael Balint emphasizes the need for clinicians to take into account the emotions of patients. On this basis, it would be possible to restore emotions to a central role in guiding the actions of researchers and clinicians alike.