Abstract EN:

This thesis analyses the social organization of médical work on patients outside of the hospital who will die without the rapid provision of médical technology - a state called "détresse vitale". Although it is widely recognized that the work to prevent the death of such patients must be performed with technical prowess under immense time constraints, the moral component of this work has been largely overlooked. This thesis begins with an analysis of the conditions of possibility for the historical évolution of emergency médical Systems in France and the United States. The second part of the manuscript contains a comprehensive sociological account of pre-hospital emergency work in which the structural constraints imposed by the form of each system are related to the work of resuscitation observed during ethnographie field research in the Paris and New York emergency médical services. The final part of this thesis is used to show that, based on professional and social values, emergency workers use socially garnered control over bare life to shape the trajectories of patients in "détresse vitale".