Existential distress: Leon Chestov's existential philosophy in the field of palliative care

Benjamin GUERIN's thesis defense in philosophy at the Université Marie et Louis Pasteur.

Existential distress is a concept developed by medical research since the turn of the 2000s. It refers to a form of extreme vulnerability, distinct from physical distress (pain, dyspnea) and psychological distress (depression). It occurs in critical or pivotal situations (burnout, prison, war, ecoanxiety, adolescence, break-ups, bereavement). Recognizing and managing this distress is a major challenge for palliative care research and practice. Indeed, this distress frequently leads patients at the end of life or suffering from serious illnesses (cancers, ALS) to request suicide or assisted dying. In our healthcare systems, this distress can reach and challenge caregivers responsible for accompanying patients facing imminent death.

This field philosophy thesis mobilizes existential philosophy to confront it with the challenges of the palliative care field. Indeed, Leon Chestov thinks particularly about existential distress, focusing on concrete cases described in literature. He thus developed an existential philosophy of the "confines", which enables us to think of existential distress as a state associated with anguish. This state is linked to a catastrophic situation experienced as a dead end. It stems from a tragic confrontation with the loss of freedom in an irremediable situation. Existence then stands on the threshold of a liminal experience, marked by the extreme tension of an untenable struggle, as it plunges into the absurd and the loss of meaning. It is therefore complex to express, because it is both unspeakable and ineffable.

This work is articulated in three stages: (1) A review of international medical literature and exploration of the conceptual roots of existential distress, in connection with psychiatry, psychology and phenomenology. (2) Exploration of a philosophy of existential distress, starting with Chestov. (3) The confrontation of these analyses with the fields constituted for this thesis: firstly, the work of interdisciplinary workshops on existential distress in Besançon (2021-2023); secondly, participation, with Harvard, in groups analyzing clinical trial data on psychedelic-assisted psychotherapies in the palliative context in the USA (2020-2024); thirdly, internships observing and analyzing concrete cases in the palliative care unit of a hospital in France (2023-2024).

Find out more:
https://logiquesagir.umlp.fr/soutenance-de-these-benjamin-guerin-mardi-21-04-2026-13h30-18h-grand-salon/

_{Pictogram kerismaker - Flaticon}