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De-tabooing dying control - a grounded theory study.

Hans O Thulesius1, Helen Scott, Gert Helgesson

  • 1Department of Clinical Sciences Malmö, Division of Family Medicine, Lund University, Lund, Sweden. hans.thulesius@ltkronoberg.se.

BMC Palliative Care
|March 19, 2013
PubMed
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This study explores the evolving societal attitudes towards end-of-life care, focusing on the de-tabooing of dying control and the rise of euthanasia and physician-assisted suicide (PAS). It identifies global variations in how dying is managed, from closed awareness to open medical control.

Area of Science:

  • Sociology of Health and Illness
  • Medical Ethics
  • Thanatology

Background:

  • Dying is an inescapable aspect of life, yet it is often neglected in contemporary healthcare settings.
  • This research addresses the current landscape of end-of-life care, aiming to develop a grounded theory on the control of dying.
  • The study specifically examines societal reactions to euthanasia and physician-assisted suicide (PAS).

Purpose of the Study:

  • To understand the current state of the field of dying and end-of-life care.
  • To develop a grounded theory explaining how individuals and societies react to issues surrounding euthanasia and physician-assisted suicide (PAS).
  • To analyze the process of de-tabooing the control of dying.

Main Methods:

  • A classic grounded theory approach was employed.

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  • Data collection involved interviews with 55 individuals (laypersons and healthcare professionals) across North America and Europe.
  • Additional data sources included surveys on PAS attitudes, scientific literature, and online discussions.
  • Main Results:

    • The 1960s marked the beginning of open awareness of death in Western healthcare, initiating a de-tabooing of controlled dying.
    • The hospice movement, palliative care, and legalization of euthanasia/PAS in various regions signify this de-tabooing process.
    • Three global models of dying control were identified: closed dying (limited palliative care), open dying with reversible medical control (palliative care, sedation), and open dying with irreversible medical control (palliative care, sedation, euthanasia/PAS).

    Conclusions:

    • The de-tabooing of dying control is presented as a secular, ongoing process.
    • This process began with open awareness contexts of dying approximately fifty years ago.
    • It continues to evolve with the expansion of palliative care and the legislative acceptance of euthanasia and PAS.