Perceptions, Attitudes, and Teaching about Death and Dying in the Medical School of the Federal University of Acre, Brazil

Abstract

Death is one of the major taboos of contemporary Western society and is a forbidden and avoided subject. If in the past it was a public and domestic event, nowadays it is hidden in hospitals crowded with professionals who are unprepared to deal with issues related to the end of life. This unpreparedness is a reflex of excessively technical and non-humanistic training which favors healing over caring. Therefore, it seems medical students are taught to work against death and not with it. In this context, we sought to trace the profile of attitudes towards death of the students graduating from the Medicine course of a public university in Brazil and evaluate how this course has prepared them to deal with issues of death and dying in their perception. We employed quantitative and qualitative methodologies by applying two data collection instruments: a questionnaire to collect sociodemographic and academic data as well as data on the teaching about death, and another to define the profile of attitudes towards death (DAP-R). We analyzed the studied variables descriptively using frequencies and means, and intercorrelated them to infer the hypotheses. We also considered student statements for analysis and discussion of results based on comments on the responses to one of the questionnaires. As results, we observed that the students’ attitude towards death was characterized by a view of death as a natural event of life (neutral acceptance), while their imagination about death was permeated with conflicting feelings; that most students had experienced the death of a patient during the course (75.8%) although most of those received no guidance in these situations (80%); that the humanistic courses concentrated the approaches on death; and that such approaches somewhat contributed to create reflection and develop abilities for managing death. We concluded that teaching about death and dying is still concentrated in few courses of the medical curriculum, mainly in the humanistic ones, and is excessively theoretical, whereas the real experiences with death during the Medicine course are treated with detachment and silence when they could be better utilized for teaching and learning about the end of life.

Exploring the impacts of a coffin-lying experience on life and death attitudes of medical and nursing students

“…Rapidly aging societies need a large number of medical care professionals to help human beings who are suffering from old age, sickness, and death. Medical education nowadays is full of excessive technical and non-humanistic training which favors healing over caring, 30 and this study sheds light on the future of medical humanities education.…”

“…The literature shows that as medical caregivers better understand or are more familiar with death, their attitudes toward death are more mature, 7,8 and their attitudes toward assisting patients or families in dealing with death will be better. 29,30 Because medical and nursing students who have the co n-lying experience exhibited reduced fear of death and avoidance behaviors, they would supposedly be able to adopt more open and mature attitudes toward death-related information, and then could more readily assist patients and families in dealing with death in their future careers. We also speculated that they might be better able to handle their own emotions of loss when facing the actual death of a patient.…”

Patient's Death From the Perspective of Nursing Students

“…Every doctor, nurse, midwife, and physiotherapist will experience patient death in his work. Most people who choose a medical faculty will encounter such a situation during their studies, which is shown by the tests carried out by future doctors [( 20 ), p. 123–133; ( 5 ), p. 110; ( 6 ), p. 108; ( 18 ), p. 207–228]. These results are consistent with our study, which showed that the vast majority of nursing students meet with the death of the patient very early, and almost all participants of master's studies experienced patient death at least once.…”

“…The authors also point out that teaching about death, dying, and caring at end of life () takes place over several meetings and is excessively theoretical, and real experiences are left unsaid [( 20 ), p. 123–133]. In 2016, it was proven that simulation could be effectively used to teach about death and dying.…”

Morte e morrer na formação médica brasileira: revisão integrativa

“…Os principais aspectos discutidos pelos artigos selecionados no que tange aos impactos psicossociais da morte e do morrer na formação médica foram aqueles ligados a seus elementos biotecnicistas; a questão do sofrimento e do despreparo diante de situações de terminalidade; as dificuldades vivenciadas pelos estudantes; e a influência de crenças e experiências pessoais. Do total de 36 artigos, 13 apresentaram críticas acerca de perspectivas da graduação médica voltadas a referências preponderantemente biomédicas organicistas e que priorizavam o tradicional paradigma científico-biológico 12,21,22,24,26,31,33,37,38,40,44,46,50 . A precariedade ou inexistência da abordagem da morte e do morrer na graduação médica resultou em um conjunto de problemas que foram identificados e discutidos nos estudos.…”