THE INTERACTION OF A DOCTOR AND A PATIENT WHEN GIVING UNWELCOME NEWS
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The aim of the study is to uncover the connections that create an interaction in situations when a patient is informed about sensitive issues regarding his sickness, dying and death. We wanted to discover the circumstances which determine what a chronically sick patient elicits about his situation, and which signs doctors use to decide how to inform the patient about his unfortunate state. We hoped to determine whether they use certain rules during the interaction as well as simultaneously respecting the individuality of each patient and his situation. In the first part we present a theoretical approach which is based upon sociological studies of medicine and death. It includes some aspects that shape an interaction during the announcement of unfavourable news. These are primarily: the displacement of dying and death from everyday life to hospitals, the limitations of medicine in treating cancer, the doctor's helplessness and uncertainty regarding diagnosis and therapy and finally the great expectations and trust which the patients have that they will be cured. In the second part we report findings gathered through a qualitative analysis of participant observation and unstructured open-ended interviews with doctors at the oncological ward, where the author worked as a volunteer. In the study we analyse three basic interaction situations: announcing the diagnosis, talking to the patient about quitting a cure, and informing him that he is dying.
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