Talking to the Dying: “Awareness of Dying” in Palliative, Multi-professional Care

Abstract

It is considered a prerequisite of a “good dying” that the dying person is aware of his imminent death. In sociology as well as in debates in the field of palliative medical care, awareness of one’s dying is treated as an essential criterion of adequate, modern and self-determined dying. In many studies, including our own, difficulties in the interaction with patients who are not willing to adjust to the “dying role” and participate in their own dying, come to the fore. While this is considered a pathology within the modern paradigm of conscious dying, which can be overcome with professional assistance, a less normative perspective is able to show that dying persons may have the desire to not to deal with their own dying. The basis for this is a systems-theoretical reconstruction of interactions in organizations, which anticipates differences of viewpoints. In this study, the paradigm of “conscious dying” will be confronted with empirical findings concerning both implicit (care staff and pastoral workers) and explicit (physicians and social workers) thematizations of dying. Palliative wards and hospices might consider it essential to provide the dying moments in which dying does not have to be addressed.