Toward a good death: an interpretive investigation of family practice residents' practices with dying patients.

BACKGROUND: Physicians' encounters with dying patients are often problematic. This study was designed to facilitate understanding of what happens when residents encounter dying patients. METHODS: The research involved observing and interviewing 28 family practice residents as they worked with dying patients. The primary research technique was that of a grounded interpretive investigation. RESULTS: We found that working toward a "good death" was a central theme of the residents' everyday actions. At critical points, however, two important forces steered residents away from this central theme: biomedical technology and anxiety. Residents reacted to these forces by distancing, moving back toward a good death, or moving further from a good death. CONCLUSION: Understanding the oscillating course toward a good death will help residents, medical educators, and other physicians deal with dying patients and their families in more meaningful and satisfying ways.