The approach of this book has been to examine the theoretical contributions from the different academic disciplines engaged in the study of death, dying and bereavement, and to set this alongside the professional context and issues faced by the different practitioners delivering health and social care. What is missing so far is any attempt to integrate these perspectives across disciplines and professions. The ‘caring professions’ have long but separate traditions of working with people who are dying or bereaved. Some, such as nursing and pastoral care, trace their whole tradition back to care of the sick and dying and are currently key members of the multidisciplinary palliative care team. Others, such as social work, found their niche in working with loss as they professionalised before Cicely Saunders, herself a one-time medical social worker, incorporated social work into her original vision of holistic care in the hospice. Psychotherapists from Freud onwards have dealt with the business of attachment and loss and the modern professions of psychiatry and clinical psychology continue to work with people who experience complicated grief. Psychiatry and psychology spawned the original formulations of grief counselling and grief therapy and continue to be active in its development, as Chapter Four explored. Clinical psychiatrists and psychologists tend to be less integrated into multidisciplinary palliative care teams, but in the forefront of dealing with suicide risk and post-traumatic stress disorder arising from disasters and other forms of traumatic loss.
Modern medicine has been rather more concerned with cure than care of the dying, but the development of palliative medicine as a specialism is spawning doctors who look outside of bio-medical models to address the wider needs of the dying person.
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