Novice Doctors’ Experience in Pronouncing Death

Abstract

Doctors routinely deal with death, but their experience and impressions toward death are not well known. Examination into how doctors perceive death has been limited mainly due to complications in re-search methods. The purpose of this study is to assess doctors` experience regarding death qualitatively by examining their first death pronouncement and to deduce their perceptions and awareness toward death related issues. Eleven first-year and second-year residents from a university hospital in Korea participated in in-depth interviews. Their comments were recorded, documented, and analyzed using grounded theory. Three major categories were identified: participants` impressions when pronouncing death, participants` views of their role in pronouncing death, and participants` views on the need for education/training in pronouncing death. The first category was further divided into personal and professional impressions. The second category illustrated a doctor`s role in pronouncing death (i.e., defining death and a doctor`s role during bereavement). All participants expressed the need to be taught how to pronounce death and asked for further training in communicating with family members of the deceased. Participants shared negative feelings regarding their experiences in pronouncing death due to a lack of education in dealing with the death of a patient. It is essential for novice doctors to clearly understand their roles in pronouncing the death of a patient, a goal that may be achieved through education programs.

본 연구는 초보 의사의 첫 사망선고 경험을 통해 의사의 죽음에 대한 경험 및 인식을 확인하고자 한 연구이다. 사망선고를 경험한 일개 대학 병원의 전공의 1, 2년차 11명을 대상으로 심층 면접을 실시하였으며, 근거이론에 의거하여 면접결과를 분석하였다. 분석 결과 크게 세 가지 범주가 도출되었다. 첫 번째 범주는 `죽음에 대한 경험`으로 죽음에 대한 `개인적인 경험`과 `전문가로서의 경험`으로 구분되었다. 두 번째 범주는 `죽음(사망선고)에 있어서 의사의 역할`로, 이 범주에는 `환자의 생사를 규정`하는 것과, `환자 가족에 대한 소극적 위로`가 포함되었다. 세 번째 범주는 `죽음 교육의 필요성`으로 연구 참여자 대부분은 사망선고와 죽음 관련 여러 쟁점에 대한 교육의 필요성에 동의하였다.