Palliative and Supportive Care

Review Articles

Journey of struggle: Kalothanasia and the hospice way of dying

Ciroaugusto Floriania1 c1 and Fermin Roland Schramma1a2

a1 Bioethics Council, Brazilian National Cancer Institute, Rio de Janeiro, Brazil

a2 Researcher of Applied Ethics and Bioethics, National School of Public Health Sérgio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil


The purpose of this article is to characterize the notion of a “good death” both historically and conceptually, grounding the philosophy of the modern hospice movement. This concept encompasses elements originating in ancient societies, such as peasant societies, where death was prepared for and shared socially, with ethical and aesthetic elements originating from Ancient Greece. These Greek elements emerged from a “journey of struggle” and can be recognized in the current day as a journey to cope with illness. From this conceptualization emerged a category of “good death” (kalothanasia), adding to the expertise of advocates of the modern hospice movement, who seek to revive a process of dying that is socially ritualized. However, this is challenging in the setting of a medical practice that is constantly incorporating new technology, in accordance with its present bio-techno-scientific paradigm, and in a medical scenario that identifies itself with the continued and persistent use of new technologies.

(Received February 15 2010)

(Accepted April 15 2010)


c1 Address correspondence and reprint requests to: Ciro Augusto Floriani, Rua Erotides de Oliveira, 44/1003, Niterói, Rio de Janeiro 24230-230, Brazil. E-mail: