Death, the doctor, and motor neurone disease : the lived experience of doctors working with people dying from MND

Sophie Dilley
2019
Working with patients who are dying has been perceived as emotionally challenging (Meier, Back & Sean Morrison, 2001), with increased awareness of concepts such as burnout and compassion fatigue pervading the media and general public. The ambiguity into the conceptualisation of these terms as well as their increasing embeddedness in the medical model risks pathologising existential responses to the givens shared by all of humanity; mortality, temporality, and making meaning. Research in the
more » ... d of death and dying continues to focus on areas such as oncology despite increasing prevalence of neurodegenerative diseases among the population (Talbot & Marsden, 2008). This research seeks to contribute to the field of MND by exploring the lived experience of doctors working with patients with MND. Semi-structured interviews were conducted with six participants, and subsequently analysed using interpretative phenomenological analysis (IPA). This research found that doctors were engaged in various meaning-making processes regarding their relationship to self and the other as patient. The super-ordinate themes identified focused on the way in which tensions were borne out of a dynamic movement of the inter-subjective relational encounter between self and other. These yielded three super-ordinate themes consisting of 'It's enjoyable, it's depressing, it's important', 'The boundaries between self and other', and 'People die'. The findings highlighted that though participants were engaged in practices of experiential avoidance to possibly distance themselves from the impact of their work, the relationality of the doctor-patient encounter had the potential to transcend the boundaries created. Furthermore, the impact of working with patients dying from MND appeared to be mitigated by the meaning doctors attributed to their work and its existential context. The implications for Counselling Psychology and allied fields are discussed, as well as limitations and suggestions for future research.
doi:10.15126/thesis.00852881 fatcat:y4ihinkzlbf5fgoljgblbbfaoa