Myocardial infarction as a chance for life: Psychocardiological implications of ethical reflections regarding conceptions of a good life in time-limited situations

Abstract

Definition of the problem: A myocardial infarction is often a vitally and emotionally threatening situation for the affected. Unconscious coping mechanisms in dealing with the heart disease may result in, for example, complete denial or emotional decompensation. Argument: An understanding of myocardial infarction as a borderline situation may provide theoretical enrichment for clinicians and point to a third coping avenue, described as “posttraumatic growth”. Affected individuals often refer to the event as a “wake-up call”. Clinical knowledge of these different coping mechanisms may in turn lead to a relativization of primarily subjectivist positions and substantively hedonistic or preferentialist notions of good life or “quality of life”. Such a position would in turn be compatible with the deliberative model of physician–patient communication. Consequences: In the light of such a broader understanding of disease coping, the task of (psychosomatic) physicians would thus to accompany persons with heart disease, to be aware of the teachable moment and to enable a process of development for the patients.