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Communication of death: ways of thinking and acting of physicians in an emergency hospital

Abstract

This study aimed to understand how physicians deal with the process of communicating death to relatives in an emergency hospital. It is a qualitative research, based on interpretive and medical anthropology. The data were collected in one of the largest public hospitals in Latin America, during nine months of participant observation. A total of 43 physicians were interviewed. The analysis was emic and guided by the model of signs, meanings and actions. Although death is a frequent event due to the seriousness of the cases being attended to, doctors perceive the experiences of the communication of death as one of the most arduous tasks of their professional practice. They use scripts, euphemisms, defensive mechanisms, emphasize clinical severity and progressively report on the worsening of the condition, so that death is expected by the family and embedded in the emergency routine. Signs and meanings are especially correlated to the biomedical paradigm, regarding it as taboo and failure, while actions evidence death and intersubjective interaction as a compulsory terrain of emotions, which occur hidden by the professional. The mentioned elements can subsidize interventions, planning and management in health care, in the field of education, workers’ health and institutional organization.

Keywords:
death; communication; medical anthropology; emergency service; hospital; physicians

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