Abstract
It might seem obvious that dealing with death anxiety in the health care system is desirable. Hence, there are either voices that demand more research on how this openness can be fostered or those who consider this topic unworthy of further investigations because of its triviality. The idea behind both deficient perspectives is that the health care system as a communication system can assume the position of a second-order observer who can account for his deficits. However, in terms of Luhmannian systems theory, external perturbations cannot force a functional system to reflect and change the structure of his communications in a certain way. The health care system as a communication system cannot do more than integrating the topic of death anxiety in terms of its functional perpetuation. For example, in hospitals, neither health care staff nor external counselors are able to address existential issues without being affected by functional and structural requirements of the hospital. We present an outline for the justification of the avoidance of death-anxiety related talk in the health care system by reference to systems theory and existential philosophy.
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References
Boyd, K., and S.A. Murray. 2010. Recognising and managing key transitions in end of life care. BMJ 341: c4863.
Bryson, Kenneth A. 2004. Spirituality, meaning, and transcendence. Palliative & Supportive Care 2(03): 321–328.
Camus, A. 1999. Le Mythe de Sisyphe: Essai sur L’absurde. Paris: Gallimard.
Cobb, Mark, Christina M. Puchalski, and Bruce Rumbold. 2012. Oxford textbook of spirituality in healthcare. Oxford: Oxford University Press.
Grant, L., S.A. Murray, and A. Sheikh. 2010. Spiritual dimensions of dying in pluralist societies. BMJ 341: c4859.
Günther, G. 1980. Ideen zu einer Metaphysik des Todes. In Beiträge Zur Grundlegung Einer Operatonsfähigen Dialektik. Band 3, 1–13. Hamburg: Felix Meiner.
Heidegger, M. 2010. Being and time. New York: State University of New York Press.
Hughes, Philippa M., Peter A. Bath, Nisar Ahmed, and Bill Noble. 2010. What progress has been made towards implementing national guidance on end of life care? A National survey of UK general practices. Palliative Medicine 24(1): 68–78.
Jaspers, K. 1973. Philosophie, Bd. 2: Existenzerhellung, 4th ed. Berlin: Springer.
Johnstone, H.W. 1978. Does death have a nature. Journal of Medicine and Philosophy 3(1): 8–23.
Jung, C.G. 1992. Psychological types. New York: Routledge Chapman & Hall.
Kübler-Ross, E. 1997. On death and dying. New York: Scribner.
Luhmann, N. 1982. Autopoiesis, action, and communicative understanding. Zeitschrift für Soziologie 11(4): 366–379.
Luhmann, N. 1987. Tautology and paradox in the self-descriptions of modern society. Zeitschrift für Soziologie 16(3): 161–174.
Luhmann, N. 1992a. What is communication? Communication Theory 2(3): 251–259.
Luhmann, N. 1992b. Die Wissenschaft der Gesellschaft, 6th ed. Frankfurt am Main: Suhrkamp Verlag.
Luhmann, N. 1994. Die Wirtschaft der Gesellschaft, 6th ed. Frankfurt am Main: Suhrkamp Verlag.
Luhmann, N. 1996a. Social systems. Stanford: Stanford University Press.
Luhmann, N. 1996b. On the scientific context of the concept of communication. Social Science Information Sur Les Sciences Sociales 35(2): 257–267.
Luhmann, N. 2006. System as difference. Organization 13(1): 37–57.
Marcel, G. 1951. Mystery of being. New York: AMS Press.
McQueen, David V. 2007. Health and modernity: The role of theory in health promotion. Berlin: Springer.
Peach, F. 2008. Death, deathlessness and existenz in Karl Jaspers’s philosophy. Edinburgh: Edinburgh University Press.
Perpich, D. 2008. The ethics of Emmanuel Levinas. Palo Alto: Stanford University Press.
Peters, L., R. Cant, S. Payne, et al. 2013. How death anxiety impacts nurses’ caring for patients at the end of life: A review of literature. The Open Nursing Journal 7: 14–21.
Puchalski, Christina M., Robert Vitillo, Sharon K. Hull, and Nancy Reller. 2014. Improving the spiritual dimension of whole person care: Reaching national and international consensus. Journal of Palliative Medicine 17(6): 642–656.
Rando, T. 1984. Grief, dying, and death: Clinical interventions for caregivers. Illinois: Research Press.
Romano, Thiago Gomes, and Henrique Palomba. 2014. Palliative dialysis: A change of perspective. Journal of Clinical Medicine Research 6(4): 234–238.
Rumbold, Bruce, and Samar Aoun. 2013. Bereavement and palliative care: A public health perspective. Progress in Palliative Care 22(3): 131–135.
Sariyar, M. 2012. Justification of ethical considerations in health economics: Merging the theories of Niklas Luhmann and Charles Taylor. Health Sociology Review 21(3): 343–354.
Scheler, M. 1986. Schriften aus dem Nachlaß, Bd. 1: Zur Ethik und Erkenntnislehre: Tod und Fortleben, 3rd ed. Bern: Bouvier.
Seale, C., J. Addington-Hall, and M. McCarthy. 1997. Awareness of dying: Prevalence, causes and consequences. Social Science and Medicine 45(3): 477–484.
Sleeman, K.E., and E. Collis. 2013. Caring for a dying patient in hospital. BMJ 346: f2174.
Taylor, C. 1992. Sources of the self: The making of the modern identity. Harvard: Harvard University Press.
Von Foerster, H. 2003. Understanding systems: Conversations on epistemology and ethics. New York: Springer.
Warsop, A. 2011. The ill body and das Unheimliche (the Uncanny). Journal of Medicine and Philosophy 36(5): 484–495.
Zimmermann, C. 2007. Death denial: Obstacle or instrument for palliative care? An analysis of clinical literature. Sociology of Health & Illness 29(2): 297–314.
Acknowledgments
I am indebted to Karim Patrick Alexander Zahri for fruitful discussions on death and death anxiety, to Elke Witt for important hints, and to the reviewers as well as the editor for their helpful comments, which improved the paper significantly.
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Sariyar, M. How to justify avoidance of communications related to death anxiety in the health care system. Med Health Care and Philos 18, 353–359 (2015). https://doi.org/10.1007/s11019-014-9609-2
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DOI: https://doi.org/10.1007/s11019-014-9609-2