Between desubjectivation and identification: medical practice with critically ill patients

The aim of this article is to analyse the subjectivity of medical practice with seriously ill people. The frequency of mortality in certain hospital wards can have traumatic effects on the physician, whose suffering results from the divide between the desire to heal and the fantasy of being an executioner in the event of repeated therapeutic failures. In this context, the practitioner's experience can oscillate between two extreme subjective positions: one, defensive, of desubjectivation of the patient; the other, emotional, of identification. These two mechanisms seem to be interwoven, as one of the functions of desubjectivation is to resist identification with the patient, which can be a source of distress. Through the testimonies of doctors in specialities such as intensive care, the author illustrates the need to recognise their emotional involvement in the relationship with patients, guaranteeing their personal and professional well-being.