What Can Words Do? Debating a "Good" Death in French Palliative Care

This article explores the ambivalent ways that care providers in a southern French hospital (the Center) thought about patient subjectivities and the power and role of language as they argued about how to orchestrate a "good" death in palliative care. By analyzing the case of Monsieur Rami, a 67-year-old Moroccan-born immigrant who died of metastatic cancer in the summer of 2017, I argue against the presumption that individual autonomy, rational choice, and linguistic transparency are hegemonic in Western Europe, particularly in biomedical domains. Instead, I use the disagreements and frustrations that surrounded Monsieur Rami's last weeks to trace out the variety of conflicting ways that care providers talked about his family entanglements, the role of cognitive knowledge and "choice" in end-of-life care, and the power of language itself. Care providers in the Center certainly sometimes characterized Monsieur Rami as a (potentially) autonomous, choosing individual who required transparent communication about his prognosis and diagnosis. But such characterizations served as ideological weapons in battles care providers were fighting amongst themselves over their own contradictory ethical commitments. And in palliative care, those competing ethical commitments were often grounded in assumptions about intersubjectivity and irrationality, as well as the performative power of words.