Existential Matters and Quality of Dying: A Model of Maturation Processes

Linda Emanuel*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: How people face mortality is a crucial matter for medicine. Yet, there is not a coherent and comprehensive understanding of how people can process the experience such that it is not traumatic. Methods: This article offers a "logic model" of how existential maturation occurs, using analogies from cell biology to explain the process. Results: This model depicts 10 mechanisms that together deal with mortality-salient events. Collectively, they are termed the existential function, which is seen as an innate, ever-evolving, integral part of the mind. An operational boundary selectively manages how realities are taken in. Processing is initiated with other essential people, ushering in reiterative steps of listening, finding, exploring, making meaning, and adjusting. The result is adaptive, integrated, mortality-acknowledging dispositions of mind. The process allows quality of life at the end of life and healthy mourning; impediments to it make for existential suffering and complicated grief. Conclusions: This conceptual model describes how people can face mortality. Its merit depends on its source in human experience, its explanatory power, its ability to guide people as they face mortality, and its ability to stimulate productive perspectives. It is therefore offered as an invitation for discussion, research, revision, and evolution.

Original languageEnglish (US)
Pages (from-to)1604-1609
Number of pages6
JournalJournal of palliative medicine
Issue number12
StatePublished - Dec 1 2023


  • continuity
  • death anxiety
  • dignity
  • essential relationships
  • existential isolation
  • existential maturation
  • good death
  • grief
  • identification
  • individuation
  • internalization
  • life review
  • meaning
  • mourning
  • peace
  • processing
  • quality of dying
  • roles
  • work of dying

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • General Nursing


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