The significance of death for doctors faced with end-of-life care of patients undergoing bone marrow transplants

This study sought to investigate the significance of death for doctors who work with terminally ill patients in the Bone Marrow Transplant (BMT) context. The research was based on a qualitative, methodological and collective case study approach, and used Dejours' psychodynamics of work as a theoretical framework. Five practitioners linked to a Bone Marrow Transplant Unit in a university hospital in São Paulo, Brazil, participated in the research. A semi-structured script was applied which addressed the personal, academic and professional experiences elicited by a terminal situation. Data were organized into two categories: "Work and professional identity: the doctor's battle against death" and "Vocation and medical training: it all beggins at home." The results show that, in the medical and hospital context, death is almost always reduced to technical rationality and this must be avoided at all costs. The significances attributed to death are rooted in the values of contemporary society and subjectively perceived through the physician's life trajectory and academic training, which influence how these professionals experience the dying process of the patients.

Attitude to death; Hospital medical team; Physician-patient relations; Palliative end-of-life care; Bone marrow transplant; Grieving