The Problems of Death and Dying from a Psychoanalytic Perspective

Abstract

In 1977, I was assigned as a doctor to a geriatric unit specialising in chronic care hospitalization which was located in the near Paris suburbs. The patients I was responsible for were very elderly people. They were on the average over 80 years old. I also knew that sooner or later they would all die in our midst. As well as being preoccupied with improving the quality of medical treatment given to them, I also wanted to improve the quality of life within the institution, and to improve the conditions of death for these very elderly people. I was familiar with Elizabeth Kubler-Ross’s (1969) work on the psychology of dying people. I knew that in England there was a hospice where the doctors were successfully using morphine to treat the suffering of terminal cancer patients. But we were in France: and this work was only known to a very few individuals. The notions of accompanying dying patients, and of palliative treatment were still not in medical vocabulary. Nonetheless, a book written by the famous oncologist, Léon Schwartzenberg and the journalist, Louis Viansson-Ponte, entitled “Changer la mort” (Changing Death) was published in 1977. This beautiful, moving book, which foresaw active euthanasia negotiated between doctor and terminal patient, was incontestably to mark French medical and social thinking on the subject, and was to influence doctors’ behaviour.