Medical specialists caring for the dying: an insight into their experiences and attitudes towards death and dying — ASN Events
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Medical specialists caring for the dying: an insight into their experiences and attitudes towards death and dying (#195)

Sofia C. Zambrano 1 2 , Anna Chur-Hansen 1 , Gregory B. Crawford 2 3
  1. Discipline of Psychiatry, The University of Adelaide, Adelaide, SA, Australia
  2. Discipline of Medicine, University of Adelaide, Adelaide, SA, Australia
  3. Mary Potter Hospice, Adelaide, SA, Australia

Background

A variety of medical specialists care for patients with life-limiting illnesses such as cancer. The literature has focused on how doctors should communicate with the dying, and how they meet the emotional demands of their profession. Despite this focus, the findings are limited and mostly prescriptive, anecdotal or quantitative.

This qualitative study explored medical specialists’ experiences and coping mechanisms when dealing with the death of their patients, and examined the differences and similarities between specialties.

Methodology

Data were collected through one-on-one, in-depth interviews and analysed through Thematic Analysis. Consistent with qualitative methodology, sampling ceased at data saturation.

Thirty-three medical specialists from Intensive Care (n=6), Palliative Medicine (n=7), Surgery (n=9), and Oncology (n=11) participated.  These specialties were chosen for their involvement at different stages of the trajectory of life-limiting illnesses.

Results

Experiences of and attitudes toward death and dying were not uniform. Participants’ accounts differed according to a number of parameters, including age and specialty. The tendency to avoid the overt expression of emotion with family and patients was frequent across specialties. The positive impact of working with the dying, mentoring, personal experiences as learning opportunities, and scarce training in dealing with their emotional reactions were recurrent themes. Differences between specialties may be attributed to disciplinary expectations of professionalism, which were apparent in the development of emotional attachments, personal involvement, and appealing to ethics, philosophy, and spirituality.

Conclusion

The differences and similarities for doctors working with the dying have implications for self-care and care of patients and families. Medical curricula can draw upon the results of this research to better prepare practitioners for dealing with death and dying.  Health professionals’ understanding of these issues may improve the support provided for medical specialists.