0670/2013 - Significado da morte para médicos frente à situação de terminalidade de pacientes submetidos ao Transplante de Medula Óssea Meaning of death for doctors in end-of-life care of patient undergoing bone marrow transplantation
• Manoel Antônio dos Santos - Santos, M.A. - Ribeirão Preto, SP - Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo - <masantos@ffclrp.usp.br>
Coautor(es):
• Fernanda Cristina de Oliveira Santos Aoki - Aoki, FCOS - Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo - <masantos@ffclrp.usp.br>
A literatura tem abordado como os profissionais de saúde significam e lidam com a morte e o morrer, porém estudos calcados na perspectiva do médico ainda são escassos. Este estudo teve como objetivo investigar o significado da morte para médicos que atuam com pacientes em condição crítica no contexto do Transplante de Medula Óssea (TMO). A pesquisa foi fundamentada no enfoque metodológico qualitativo e no estudo de caso coletivo, e utilizou o referencial teórico da psicodinâmica do trabalho. Participaram os cinco médicos vinculados a uma Unidade de TMO de um hospital universitário do interior paulista. Aplicou-se um roteiro semiestruturado, que abordava as vivências pessoais, acadêmicas e profissionais suscitadas pela situação de terminalidade. Os dados foram sistematizados nas categorias: “Trabalho e identidade profissional: a peleja do médico contra a morte” e “Vocação e formação médica: tudo começa em casa”. Os resultados mostram que, no âmbito médico-hospitalar, a morte é quase sempre reduzida à racionalidade tecnicista e por isso deve ser combatida a qualquer custo. As significações atribuídas à morte são ancoradas nos valores da sociedade contemporânea e subjetivadas nos percursos e percalços enfrentados pelo médico ao longo de sua história de vida e na formação acadêmica, que influenciam o modo como os profissionais vivenciam o processo do morrer dos pacientes. No embate perene entre vida e morte, o paciente em situação de terminalidade simboliza a temivel derrota do médico, o que o leva a manter cauteloso distanciamento.
Palavras-chave:
Atitude frente à morte
Corpo clínico hospitalar
Relações médico-paciente
Cuidados paliativos na terminalidade da vida
Transplante de medula óssea
Luto
Abstract:
Literature has addressed how health professionals mean and deal with death and dying, but studies rooted in the perspective of the doctor are still scarce. This study aimed to investigate the meaning of death for doctors who work with terminally ill patients in Bone Marrow Transplantation (BMT) context. The research was based on qualitative methodological approach and collective case study, and used Dejours’ psychodynamic of work as theoretical framework. Participants were five practitioners linked to a Unit of Bone Marrow Transplantation in a university hospital in São Paulo, Brazil. We applied a semi-structured which addressed the personal, academic and professional experiences raised by a terminal situation. Data were organized into categories: "Work and professional identity: the doctor’s battle against death" and "vocation and medical training: it all starts at home." The results show that, in the medical and hospital context, death is almost always reduced to rationality and technicality and therefore must be resisted at all costs. The meanings attributed to death are anchored in the values of contemporary society and structered on pathways and obstacles faced throughout his life story and in academia, which influence how professionals experience the process of dying patients. In the perennial struggle between life and death, the patient in a terminal situation becomes a symbol of the defeat of the doctor, which leads the practitioner to maintain a cautious distance.
Keywords:
Attitude to death
Medical staff - hospital
Physician-patient relations
Hospice care
Bone Marrow Transplantation
Grief
Meaning of death for doctors in end-of-life care of patient undergoing bone marrow transplantation
Resumo (abstract):
Literature has addressed how health professionals mean and deal with death and dying, but studies rooted in the perspective of the doctor are still scarce. This study aimed to investigate the meaning of death for doctors who work with terminally ill patients in Bone Marrow Transplantation (BMT) context. The research was based on qualitative methodological approach and collective case study, and used Dejours’ psychodynamic of work as theoretical framework. Participants were five practitioners linked to a Unit of Bone Marrow Transplantation in a university hospital in São Paulo, Brazil. We applied a semi-structured which addressed the personal, academic and professional experiences raised by a terminal situation. Data were organized into categories: "Work and professional identity: the doctor’s battle against death" and "vocation and medical training: it all starts at home." The results show that, in the medical and hospital context, death is almost always reduced to rationality and technicality and therefore must be resisted at all costs. The meanings attributed to death are anchored in the values of contemporary society and structered on pathways and obstacles faced throughout his life story and in academia, which influence how professionals experience the process of dying patients. In the perennial struggle between life and death, the patient in a terminal situation becomes a symbol of the defeat of the doctor, which leads the practitioner to maintain a cautious distance.
Palavras-chave (keywords):
Attitude to death
Medical staff - hospital
Physician-patient relations
Hospice care
Bone Marrow Transplantation
Grief
Santos, M.A., Aoki, FCOS, Oliveira-Cardoso, E.A.. Significado da morte para médicos frente à situação de terminalidade de pacientes submetidos ao Transplante de Medula Óssea. Cien Saude Colet [periódico na internet] (2013/Mai). [Citado em 05/11/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/significado-da-morte-para-medicos-frente-a-situacao-de-terminalidade-de-pacientes-submetidos-ao-transplante-de-medula-ossea/13016?id=13016