Death and Dying

TLDR

Over centuries, death has shifted from a natural, accepted event to a lonely, painful hospital ordeal overseen by physicians. The study argues that during terminal illness, physicians should transition from curative to caregiving roles, requiring a comprehensive grasp of the adaptive stages from denial to acceptance. This transition demands that physicians recognize the physical and psychological components that make up the pain of dying.

Abstract

Attitudes toward death have changed dramatically over the centuries. Death had been viewed as a natural event to be accepted without undue fear, and presided over by the dying person. In recent times, however, death has been transformed into a lonely and frequently painful ordeal occurring in the isolation of a hospital room, presided over by the physician and other health care personnel. In the course of a terminal illness, the role of the physician should change from curing to caring. This role needs a full understanding of the various adaptive stages involved in facing death, from initial denial to ultimate acceptance. The physician must also appreciate the various components, both physical and psychological, that constitute the pain of dying.