Introduction

This book has been written for those who must work with and give care to the dying. Our discussion is not simple narrative or description; it is a "rendition of reality," informed by a rather densely woven and fairly abstract theoretical scheme. This scheme evolved gradually during the course of our research.

Audience and Focus

The second audience for this volume is social scientists who are less interested in dying than they are in useful substantive theory. Our central concern is with the temporal aspects of work. The theory presented here may be useful to social scientists interested in areas far removed from health, medicine, or hospitals.

Training of Medical Professionals

The training of physicians and nurses equips them for the technical aspects of dealing with illness. Medical students learn not to kill patients through error, and to save lives through diagnosis and treatment. But their teachers put little or no emphasis on how to talk with dying patients; how—or whether—to disclose an impending death; or even how to approach the subject with the wives, husbands, children, and parents of the dying.

Students of nursing are taught how to give nursing care to terminal patients, as well as how to give "post-mortem care." But the psychological aspects of dealing with the dying and their families are virtually absent from training.

Professional Conduct and Social Assumptions

Although physicians and nurses are highly skilled at handling the bodies of terminal patients, their behavior to them otherwise is actually outside the province of professional standards. Much, if not most, nontechnical conduct toward, and in the presence of, dying patients and their families is profoundly influenced by "common sense" assumptions, essentially untouched by professional or even rational considerations or by current advancement in social-psychological knowledge.

Impact of Hospital Environment

The process of dying in hospitals is much affected by professional training and codes, and by the particular conditions of work generated by hospitals as places of work.