Approach to death in medical graduation: students’ perceptions in light of Freudian contributions

Abstract

Introduction: In western contemporary society, attempts to prevent death and suffering promote a medical training focused on dealing mostly with the biological aspects of illness and death, to the detriment of the psychosocial aspects related to those issues. Objective: The authors intended to identify medical students’ perceptions about the approach to death and dying in the light of Freudian theory about death. Method: This was a qualitative study with an exploratory approach, developed based on six focal groups consisting of 55 students from all the undergraduate medical school semesters from a federal university in the interior of the state Minas Gerais. The data produced was analyzed according to the thematic or category-based content analysis, from which the following categories emerged: 1- The death topic in undergraduate medical school; 2- The medical professional facing death. Results: To discuss death and dying in the formative process is to talk about the anguish in the face of human finitude. The students identified the approach to death and dying in undergraduate school, but in a limited and insufficient way. They indicated the need to increase contact with the topic in the curriculum, and to include, in a mandatory way, the contents on Palliative Care. The medical role encompasses both the care focused on healing and the assistance in moments when healing is not possible. The preparation to deal with death throughout undergraduate training involves personal conceptions and experiences, undergraduate practice, access to theoretical contents, specificities and subjective aspects related to each situation. The mentioned resources to deal with death, in addition to the studies, were religiosity and psychotherapy. Conclusion: To approach death in undergraduate medical curricula involves great complexity and challenges. From the viewpoint of psychological reality, human beings try to deny death and avoid suffering. Thus, the challenges in medical formation and practices consist in assuming the indissociable articulation between the biological, cultural and psychosocial aspects. To take care of life is also to take care of death and avoiding it may cause greater suffering to the patients, family members, students and medical professionals.