The end stage of a disease is a critical condition of the human life. This state is dominated by suffering, physical impairment and by activities that are aimed to satisfying the basic necessities of everyday (relief of pain, alimentation, personal hygiene etc.). The lives of patients change dramatically and occur a number of attempts to the adaptation that precede the exitus. This situation causes intense feelings and emotional reactions in physicians.

The purpose of this study is to analyze the reactions of physicians to terminally ill patients.

The consultative psychiatry in University Hospital of Sassari has allowed us to observe specific physician’s reactions to patients with terminal illnesses.

The thought of death generates fear, global depression and suffering in patients. Consequently, the specter of death, because of its seriousness, causes a psychological rejection in the physician also. Frequently there is a difficulty to accept the patient's pain, to communicate with him clearly and with empathy. The emotional reactions of the physicians are denial, avoidance and splitting as defence mechanisms.

In the light of these considerations we believe that it is necessary an appropriate training of health staff about this type of patients and a special attention of the psychiatrist to the discomfort of physicians.