Significado da morte para médicos frente à situação de terminalidade de pacientes submetidos ao Transplante de Medula Óssea

Abstract

This study sought to investigate the significance of death for doctors who work with terminally ill patients in the Bone Marrow Transplant (BMT) context. The research was based on a qualitative, methodological and collective case study approach, and used Dejours' psychodynamics of work as a theoretical framework. Five practitioners linked to a Bone Marrow Transplant Unit in a university hospital in São Paulo, Brazil, participated in the research. A semi-structured script was applied which addressed the personal, academic and professional experiences elicited by a terminal situation. Data were organized into two categories: "Work and professional identity: the doctor's battle against death" and "Vocation and medical training: it all begins at home." The results show that, in the medical and hospital context, death is almost always reduced to technical rationality and this must be avoided at all costs. The significances attributed to death are rooted in the values of contemporary society and subjectively perceived through the physician's life trajectory and academic training, which influence how these professionals experience the dying process of the patients.

Brazilian Health Professionals’ Perception about Death: An Integrative Review

“…Confirmation of the difficulty of professionals to deal with the theme recurs in the published studies on the subject, showing that even this death is still faced as strange fact and not well-liked by health workers [4].…”

“…In the analysis of magazines, periodicals stand out in nursing [9,11,14,16,[18][19][20]22] medical [4,17] of public health [10,21], bioethics [12] and in other areas [13,15]. Table 2 shows the characterization of selected articles, according to the authors, title, journal, volume, number and year of publication.…”

“…Table 2 shows the characterization of selected articles, according to the authors, title, journal, volume, number and year of publication. Fraga e col., [12] Meaning, to the doctors, the completion of life and palliative care.…”

“…Then the discussions will be exposed. After reviewing the research, the variety of perceptions about death, reported by studies, provided the division of articles on: life stage [9-11, 15-16, 18-21]; technicist conception [4,[12][13]17]; moving to a better place [13]; freedom from suffering [14] and unexpected interruption of life [20,22].…”

“…In confirmation to this category, the evaluation of the meaning of death for 20 doctors from the Clinical Hospital Samuel Libânio allows the statement that the understanding of the dying process is the cessation of brain activity, highlighting the biological and technical vision of physicians assisting terminal patients [12].…”