Actitudes psicológicas ante la muerte y el duelo. Una revision conceptual

Abstract

Introduction: Death has always been the object of deep philosophical, religious, and currently scientific reflections; however in post-industrial societies it is difficult to accept the very idea of it, so that attitudes to death have undergone maladaptive evolution, drawing back in the name of "progress" from the healthy attitudes of confrontation and acceptance, to the pre-phobic attitude of living in constant worry for fear of death, and the phobic attitude of its denial. Socio-cultural changes: In the West we can differentiate two periods in the experience of dying: one prior to institutionalization in hospital where it is accepted as a natural part of existence and the other, from when the hospital becomes the institution reserved for dying, bringing about a radical change in the consciousness of and information on ones own death. Attitudes of medical personnel: These changes have also reached medical personnel, frequently generating distorted attitudes such as not wanting to name death or the pathologies leading to it, not dealing face-to-face with the terminal patient, incongruities and discord between verbal and non-verbal communication and an increase in technological attention in detriment of affective empathy, with the risk of therapeutic cruelty, worsening the conditions of death, Conclusion: The medical framework needs ethical and aesthetic arrangements to integrally face the process of dying, endowing it with adequate means, knowledge and attitudes to attend the biopsychosocial needs of the dying, with the object of dying with dignity.