Disentimiento en el tratamiento hemodialítico de pacientes con insuficiencia renal. Una mirada psicoanalítica del sujeto con enfermedad renal crónica en una institución de salud en la ciudad de Guayaquil.

Abstract

The purpose of this project is to analyze, using psychoanalytic theory, the possible causesof dissent in the hemodialysis treatment of patients with chronic renal failure in a health institution in the city of Guayaquil. Being aware of the dissent (denial) to the treatment asa response of the subject (patient) inside a health institution and undergoing the changes that the diagnosis of the disease implies beneath the implementation of a life support machine such as hemodialysis. Also, this thesis seeks to contrast the medical proposal within the protocol with the patient's response, at the time of accepting said treatment, using "informed consent" as an action tool at the time of validating an "acceptance" overthe procedure. We pretend to analyze the discourse of the health institution how is it implied and how it affects the patient's decision, from the place that the patient have in this institution discourse. For this we will use psychoanalytic theory and the elaboration of clinical vignettes, in order to find points of intersection and segregation between psychoanalytic and medical discourse and what patients can tell us about their hemodialysis experience. Locating a possible way of acting from the psychoanalytic clinic, using the transference and the logical times proposed by Lacan, as a means of actionagainst the emergency proposed by chronic renal failure. This work is an effort of engagement, in the eternal disengagement between health institutions and psychoanalytical practice.