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Published in: Supportive Care in Cancer 4/2006

01-04-2006 | Original Article

Dying with dignity according to Swedish medical students

Authors: Marit Karlsson, Anna Milberg, Peter Strang

Published in: Supportive Care in Cancer | Issue 4/2006

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Abstract

Goal of work

To die with dignity is an important but ambiguous concept, and it is used in contradictory contexts, both for the promotion of palliative care and as an argument for euthanasia. Our goal was to explore medical students’ definition of a dignified death.

Patients and methods

A questionnaire containing open-ended questions was answered anonymously by 165 first- and fifth-year medical students. The data were analysed using qualitative content analysis with no predetermined categories.

Main results

The students’ descriptions of a dignified death resulted in five categories of death: (1) without suffering, (2) with limited medical interventions, (3) with a sense of security, which implied a safe environment nursed by professional staff, (4) with autonomy, respect for the individual and empowerment to the patient and (5) with acceptance. These findings show similarity to the established concepts of a good death, as well as the view of a dignified death by terminally ill patients.

Conclusions

The data suggest that the students perceive that the medical system is over-treating patients and sometimes causing harm to dying patients. The results reveal a potential misunderstanding and contradiction relating to death without suffering and the use of necessary palliative interventions. These findings are important when planning education as regards palliative care and dignified death.
Literature
1.
go back to reference Balaskas J (1989) Active birth. Unwin, London Balaskas J (1989) Active birth. Unwin, London
2.
go back to reference Billings JA, Block S (1997) Palliative care in undergraduate medical education: status report and future directions. JAMA 278(9):733–738PubMedCrossRef Billings JA, Block S (1997) Palliative care in undergraduate medical education: status report and future directions. JAMA 278(9):733–738PubMedCrossRef
3.
go back to reference Bradbury M (1999) Representations of death: a social psychological perspective. Routledge, London Bradbury M (1999) Representations of death: a social psychological perspective. Routledge, London
4.
go back to reference Chochinov HM (2002) Dignity in the terminally ill: a cross-sectional, cohort study. Lancet 360:2026–2030PubMedCrossRef Chochinov HM (2002) Dignity in the terminally ill: a cross-sectional, cohort study. Lancet 360:2026–2030PubMedCrossRef
5.
go back to reference Chochinov HM, Hack T, McClement S et al (2002) Dignity in the terminally ill: a developing empirical model. Soc Sci Med 54:433–443PubMedCrossRef Chochinov HM, Hack T, McClement S et al (2002) Dignity in the terminally ill: a developing empirical model. Soc Sci Med 54:433–443PubMedCrossRef
6.
7.
go back to reference Dekkers W; Sandman L, Webb D (2002) Good death or good life as a goal of palliative care In: ten Have H, Clark D (eds) The ethics of palliative care: European perspectives. Open University Press, Philadelphia, pp 106–125 Dekkers W; Sandman L, Webb D (2002) Good death or good life as a goal of palliative care In: ten Have H, Clark D (eds) The ethics of palliative care: European perspectives. Open University Press, Philadelphia, pp 106–125
8.
go back to reference DelVecchio Good M, Gadmer N, Ruopp P et al (2004) Narrative nuances on good and bad deaths: internists’ tales from high-technology work places. Soc Sci Med 58:939–953PubMedCrossRef DelVecchio Good M, Gadmer N, Ruopp P et al (2004) Narrative nuances on good and bad deaths: internists’ tales from high-technology work places. Soc Sci Med 58:939–953PubMedCrossRef
9.
go back to reference Emanuel EJ, Emanuel LL (1998) The promise of a good death. Lancet 351:21–29CrossRef Emanuel EJ, Emanuel LL (1998) The promise of a good death. Lancet 351:21–29CrossRef
10.
go back to reference Hart B, Sainsbury P, Short S (1998) Whose dying? A sociological critique of the ‘good death’. Mortality 3(1):65–77CrossRef Hart B, Sainsbury P, Short S (1998) Whose dying? A sociological critique of the ‘good death’. Mortality 3(1):65–77CrossRef
11.
go back to reference Hickey G, Kipping C (1996) A multi-stage approach to the coding of data from open-ended questions. Nurse Res 4:81–91 Hickey G, Kipping C (1996) A multi-stage approach to the coding of data from open-ended questions. Nurse Res 4:81–91
13.
go back to reference Kissane DW, Clarke D, Street A (2001) Demoralization syndrome—relevant psychiatric diagnosis for palliative care. J Palliat Care 17(1):12–21PubMed Kissane DW, Clarke D, Street A (2001) Demoralization syndrome—relevant psychiatric diagnosis for palliative care. J Palliat Care 17(1):12–21PubMed
14.
go back to reference Macklin R (2004) Reflections on the human dignity symposium: is dignity a useless concept? J Palliat Care 20(3):212–216PubMed Macklin R (2004) Reflections on the human dignity symposium: is dignity a useless concept? J Palliat Care 20(3):212–216PubMed
15.
go back to reference Mak J, Clinton M (1999) Promoting a good death: an agenda for outcomes research—a review of the literature. Nurs Ethics 6(2):97–106PubMedCrossRef Mak J, Clinton M (1999) Promoting a good death: an agenda for outcomes research—a review of the literature. Nurs Ethics 6(2):97–106PubMedCrossRef
16.
go back to reference Marton F, Dahlgren LO, Svensson L, Säljö R (1977) Inlärning och omvärldsuppfattning (Learning and conception of the world). AWE/Gebers, Stockholm Marton F, Dahlgren LO, Svensson L, Säljö R (1977) Inlärning och omvärldsuppfattning (Learning and conception of the world). AWE/Gebers, Stockholm
17.
go back to reference McDonald M (2004) Dignity at the end of our days: personal, familial, and cultural location. J Palliat Care 20(3):163–170PubMed McDonald M (2004) Dignity at the end of our days: personal, familial, and cultural location. J Palliat Care 20(3):163–170PubMed
18.
go back to reference McNamara B (2004) Good enough death: autonomy and choice in Australian palliative care. Soc Sci Med 58:929–938PubMedCrossRef McNamara B (2004) Good enough death: autonomy and choice in Australian palliative care. Soc Sci Med 58:929–938PubMedCrossRef
19.
go back to reference Morgan DL (1993) Qualitative content analysis: a guide to paths not taken. Qual Health Res 3:112–121PubMedCrossRef Morgan DL (1993) Qualitative content analysis: a guide to paths not taken. Qual Health Res 3:112–121PubMedCrossRef
21.
go back to reference Payne S, Hillier R, Langley-Evans A et al (1996) Impact of witnessing death on hospice patients. Soc Sci Med 43(12):1785–1894PubMedCrossRef Payne S, Hillier R, Langley-Evans A et al (1996) Impact of witnessing death on hospice patients. Soc Sci Med 43(12):1785–1894PubMedCrossRef
22.
go back to reference Pullman D (2004) Death, dignity, and moral nonsense. J Palliat Care 20(3):171–178PubMed Pullman D (2004) Death, dignity, and moral nonsense. J Palliat Care 20(3):171–178PubMed
23.
go back to reference Seale C (2004) Media constructions of dying alone: a form of ‘bad death’. Soc Sci Med 58:967–974PubMedCrossRef Seale C (2004) Media constructions of dying alone: a form of ‘bad death’. Soc Sci Med 58:967–974PubMedCrossRef
24.
go back to reference Statens offentliga utredningar (Official government commission) (2001) Döden angår oss alla—värdig vård vid livets slut (Death becomes us all—dignified care at the end of life). SOU 2001:6, Fritzes, Stockholm Statens offentliga utredningar (Official government commission) (2001) Döden angår oss alla—värdig vård vid livets slut (Death becomes us all—dignified care at the end of life). SOU 2001:6, Fritzes, Stockholm
25.
go back to reference Street A, Kissane DW (2001) Constructions of dignity in end-of-life care. J Palliat Care 17(2):93–101PubMed Street A, Kissane DW (2001) Constructions of dignity in end-of-life care. J Palliat Care 17(2):93–101PubMed
26.
go back to reference Toombs KS (2004) Living and dying with dignity: reflections on lived experience. J Palliat Care 20(3):193–200PubMed Toombs KS (2004) Living and dying with dignity: reflections on lived experience. J Palliat Care 20(3):193–200PubMed
27.
go back to reference Yalom I (1980) Existential psychotherapy. Basic Books Inc., New York Yalom I (1980) Existential psychotherapy. Basic Books Inc., New York
29.
go back to reference van der Maas P, van der Wal G, Haverkate I et al (1996) Euthanasia, physician-assisted suicide, and other medical practices involving the end of life in the Netherlands, 1990–1995. N Engl J Med 335:1706–1711PubMedCrossRef van der Maas P, van der Wal G, Haverkate I et al (1996) Euthanasia, physician-assisted suicide, and other medical practices involving the end of life in the Netherlands, 1990–1995. N Engl J Med 335:1706–1711PubMedCrossRef
30.
go back to reference Weber RP (1990) Basic content analysis. Sage publications, Newbury Park Weber RP (1990) Basic content analysis. Sage publications, Newbury Park
31.
go back to reference Vig EK, Pearlman RA (2004) Good and bad death from the perspective of terminally ill men. Arch Intern Med 164:977–981PubMedCrossRef Vig EK, Pearlman RA (2004) Good and bad death from the perspective of terminally ill men. Arch Intern Med 164:977–981PubMedCrossRef
Metadata
Title
Dying with dignity according to Swedish medical students
Authors
Marit Karlsson
Anna Milberg
Peter Strang
Publication date
01-04-2006
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 4/2006
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-005-0893-5

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