Ethics of Death and Dying: Historical Perspective

Abstract

The ethical dilemmas surrounding dying and death today can be understood more adequately when placed in an historical perspective. The methodology of intellectual history is employed to examine the sequence of cultural stages from prehistory to the contemporary scene, using the concept of the death system (Kastenbaum) as an organizing formulation. It is suggested in conclusion that a modern version of the meliorist ethos can lend support to the on-going modes of biomedical research and the application of the activist therapeutic principle in medical practice. Humanity has labored and suffered too much to abandon hope at this time and either submerge the personality of the individual or turn to a nihilistic “death worship” (Borkenau).

Muerte, diagnóstico y evento

“…En el período paleolítico, cuando el ser humano tenía una percepción naturalmente primitiva o instintiva, la muerte era considerada una transformación. Los ritos que permitían el paso seguro del cuerpo tenían función agregada en términos de organización social 3 . Se trata de un período de la prehistoria en el que se vivía en grupos nómadas y, por eso, las interpretaciones de esa época son básicamente conjeturas basadas en escasa evidencia.…”

“…En este contexto, surgieron los mitos de resurrección, a partir de la idea de una renovación periódica representada por la observación del ciclo de las estaciones y de la secuencia de la siembra y cosecha. Además, esta nueva visión de la renovación de las comunidades agrícolas se asoció con los conceptos tanto de resurrección como de renacimiento, dando lugar a las grandes tumbas, que simbolizaban esta creencia 3 .…”

“…En el antiguo Egipto, el desarrollo de la sociedad y el aumento de la calidad de vida humana reemplazaron gradualmente la idea de la muerte por un concepto de la inmortalidad, una vez reservada a dioses y faraones. La muerte se considera una transición a una existencia eterna, basada en la moralidad 3 .…”

Morte, diagnóstico e evento

“…No período paleolítico, quando o ser humano tinha uma percepção naturalmente primitiva ou instintiva, a morte era considerada uma transformação. Os ritos que permitiam a passagem segura do corpo tinham função agregadora em termos de organização social 3 . Trata-se de um período da pré-história em que se vivia em grupos nômades e, por isso, as interpretações dessa época são basicamente conjecturas baseadas em evidências escassas.…”

Freud's Physician-Assisted Death

“…In other words, when making difficult medical decisions, there is a tendency to favor action over inactioneven when action is believed to have little or no benefit, it is emotionally easier to "do something" than to do nothing. 24,25 It is perhaps ironic that physicians are likely to be more conservative than their patients in their personal preferences for use of technology at the end of life. [26][27][28][29] We believe that patients' demands for autonomy in medical decision making, and their fears that they cannot control the overuse of medical technology in their final days, will result in more requests to physicians for help to end the suffering through euthanasia.…”