Resumo de Ondeath And Dying - Elizabeth Kubler-Ross

SHVOONGABSTRACTSElizabeth Kubler-Ross MD Graduated to ?dance among the galaxies? on August 24, 2004. She left behind a legendary body of work epitomized by her book entitled ?On Death and Dying?, published in 1969. She was a Psychiatrist with a keen sense of compassion and understanding and the courageous examination of the process of the end of life was her lifetime passion. This world is so much better for her efforts, she left behind a large number of publications on this subject and paved the way for the Medical field currently known as Compassionate Care, Hospice Care and End of Life. Primarily she started the process of discussing the painful issues of death with terminally ill patients. In the course of her elegant and visionary work, the real teachers of the wisdom are the dying patients themselves. They finally have a voice that can be heard. Many of them resented the culture of silence and smoke-screens that had been associated with the nearness of death in clinical settings until Dr. Kubler-Ross?s eliminated the taboos surrounding this subject. Fear of death is a universal thing, an extension of the instinct of survival. The silence surrounding the final days of medical patients has for centuries made the process harder than it has to be. The comments made by actual patients in interviews with the End of Life Psychiatric team shows that upon asking some of them what was wrong they blankly stated: I?m full of Cancer, I will die soon. They had realized it fully while family members, doctors and nurses tip-toed around the implicit secret of their advanced illness. The old, silent approach to the fear of death isolated the patient and didn?t allow them to enjoy the companionship of others to ease their passage into the other side of the cradle in an honest and compassionate way. In her words, however she stated that man has not basically changed. Death is still a fearful, frightening happening and the fear of death is a universal fear even if we think we have mastered it on many levels. Through her interviews with terminally ill subjects it is clear that guilt and unresolved personal conflicts are the worst companions in a death-bed. Those who left their affairs in order had a more resolute attitude to face the last task in the life of a human being, to die.Her introduction of the theme relates the memory of death-bed scenes of elderly individuals in Europe, dying of Natural Causes, - old age - friends and relatives came by the house to pay their respects and bid adieu to the dying person, a community phenomenon to assist the dying person and their families. In contrast modern western medicine inflicts many hardships on the patients, beginning with emergency ambulance rides, operations, prolonged hospital stays and suffering with the inevitable outcome of death all the same in many cases. The interdisciplinary Seminar on death and Dying started in Chicago in 1965 with the assistance of Theology students and Psychiatrists to address the issues surrounding this crisis in human life on about 200 dying patients. The bulk of the data was collected on terminally ill patients of Cancer and other long term illnesses. The findings may not apply equally well to sudden death, accidental or otherwise. The findings of the project are discussed in the book. The initial response was very negative by members of the Medical Profession, but with the help of some courageous study subjects a panorama of the process was outlined. There are five stages that have been discovered by the study. 1- Denial and Isolation.- A phase that is summed by the statement: No it cannot be true, not me, there must be a mistake. The initial shock of facing one?s own terminal illness.2.-Anger, this is the next stage. The patient asks Why me? Why not the old man down the street, he is much older, he drinks, etc, etc, a process of rationalizing the reasons why one should not be the one to die. 3.-Bargaining.This is a process of attempting to postpone theinevitable, until I can attend my son?s wedding, or until I can sing a recital for the last time. At the bottom of it is the wish of the dying patient to postergate death indefinitely in return for ?good behavior?.4.- Depression. The immense sum of all the little tortures and sufferings of the terminally ill bring about a sense of great loss, unable to shrug it off any longer. Guilt, Sadness, are elements involved in this preparation for the final separation from this world. 5.- Acceptance. Given enough time and assistance, a dying patient may reach a stage in which he is no longer sad or angry about his fate. The patient may be weak and spend long periods of time sleeping for comfort, in an emulation of the frequent sleep of the newborn, in a reversal of sequence. Often these patients are open to a brief visit, in silence, holding our hand, accepting our company and comfort. Nor every patient reaches this stage of maturity, some fight to he end and succumb to the inevitable.This book is a cornerstone in the understanding of life and death in human behavior;lessons taught to Dr. Kubler-Ross by her patients / subjects and so ably interpreted and digested for all of us, mortal human beings who may need them one day.

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