As a young undergraduate psychology student, I once had the opportunity to attend a number of post-mortem examinations in a general hospital in England where I was spending a study period. I learned a lesson on that occasion which has stayed with me for the past 20 years.

The post-mortem was conducted on a 70-year-old male who had died of a heart attack. I found it most interesting. Here were the organs - the heart, the kidneys, the liver; there were the heart valves; so that's what the brain looks like. I had seen pictures and diagrams but never the real thing.

The atmosphere was relaxed, supportive and intellectually stimulating. The pathologist, a nice man, took great pains to explain to a young student the structure and workings of the various organs being dissected and the exercise was a very satisfying one intellectually.

When the post-mortem was completed, the body was stitched up, suited, placed in a coffin, and wheeled to a small mortuary chapel close by to await the arrival of the deceased's relatives. It was at that moment I learned my lesson.

This body which had been a source of intellectual curiosity in the antiseptic clinical surroundings of the pathology department suddenly regained its personhood when laid out in a mortuary with a small altar close by on which were candles, a crucifix and a small container of oil. No longer was this an intellectual curiosity but somebody's father, husband, son, friend, colleague, loved one. This was someone who had lived a life - eaten, worked, argued, wept, played, loved. The shift in my perception was sudden and dramatic and, to be honest, a bit traumatic. What had been tissue was now a person, albeit dead.

It taught me that context has an enormous impact on our perception of events and that our understanding can be dramatically altered by the cognitive and perceptual frame we bring to events.

I was reminded of this experience some six years later when my father was tragically killed in a road accident. My older brother and I travelled to the hospital to bring home my father's body, but it could not be released as the post-mortem had yet to be conducted.

Knowing what was involved, I asked the pathologist and the mortuary attendant whether the post-mortem scars and some of the injuries on my father's face might be hidden in some way as we wished to open the coffin at the wake. Imagine how we felt on returning to the mortuary to find that my father's head had been covered by an old shower cap to hide the scarring.

A deep chasm often seems to exist between the medical system and members of the public. This is now being brought into sharp focus by the unfolding of the sad saga of the retention of children's organs by the maternity hospitals for the purpose of further study and research. Tragically, as seems to have been the norm at the time, parental consent was not sought and many parents are now suffering from deep anguish upon the reopening of wounds they may have considered at least partially healed.

How do these dramatically differing perceptions arise? I do not believe it is simply a matter of insensitivity on the part of the medical profession. In my experience, doctors are caring people who try to do their best, often under very stressful and trying circumstances, for their patients. They are also often concerned with what they would see as the greater good which finds its expression in conducting research aimed at diminishing the impact of disease and improving the quality of life of their patients.

However, it is in dealing with the psychological aspects of the doctor-patient encounter that problems most frequently arise. Ninety per cent of the complaints made by the public about their experience of healthcare are the result of communication failure. Why is this so, and what can be done about it?

Doctors are concerned mainly with disease and its treatment or, in the case of chronic disease, its long-term management. Their training has created what is largely an intellectual frame of reference in which biology, pathology and pharmacology are the cornerstones.

Their earliest training in the anatomy dissection room is structured to encourage a detached analysis of structure and function. Anatomy dissection rooms are deliberately clinical, brightly lit and the practices and procedures are designed to ensure that the student is introduced gradually to dissection and not traumatised by the experience.

While the bodies are treated with respect, the emphasis is on detached observation and learning. Such detachment is important as it prepares the medical student for what might otherwise be a lifetime of wrenching emotional experiences. This objective, scientific, somewhat detached approach is further developed through clinical training.

The primary goal of the doctor or surgeon is to treat the problem using the best and safest method possible. Doctors, therefore, generally bring a somewhat detached, problem-solving approach to their practice of medicine and in so doing they reflect the prevailing scientific paradigm. The most common defence mechanisms seen in hospitals are intellectualisation and detachment. As one oncologist said to me: "I laugh so that I might not cry." Such defences are seen as important in dealing continually with illness, suffering and death.

Patients and relatives, however, come to hospital with a very different perceptual framework. Hospitals can be frightening places for the uninitiated. They are strange, often impersonal environments. Everybody else seems to know their role, but many patients are anxious, worried, unsure and lacking information about what is to happen to them. Furthermore, patients are often afraid to ask questions because everybody is so busy, because they don't want to be a nuisance or simply because they don't know what questions they should ask.

The most common complaint of hospital patients is that not enough information is given to them. The hospital system has evolved to deal with the biological components of disease and illness, the psychological needs of patients and relatives generally being considered to be less important. And yet research has shown that by attending to the psychological needs of patients, one can significantly improve their satisfaction with hospital and even improve recuperation. For example, adequate psychological preparation before surgery has been shown to significantly improve post-operative recovery and decrease the need for pain medication.

We humans are complex beings. Not only are we complex physical systems, but we are also complex psychological systems. Nowhere is our psychological complexity more obvious than when faced with our own death or with the death of someone we love. Such situations go to the core of our being, challenge our ability to maintain meaning and stir our deepest unconscious fears.

When faced with the death of a loved one, we search for meaning and, with time, closure. The rituals which have evolved around death in our society have very important psychological benefits. When verbal expression is inadequate, ritual expression fills the vacuum and symbolism becomes paramount.

Everyone who has been bereaved knows the importance of the rituals surrounding burial. The loss of someone at sea stimulates an intensive search for the body of the victim. The ongoing trauma of the relatives of those killed by paramilitaries whose bodies have never been located testifies to the importance of having a body to mourn and inter.

The current situation in which parents find themselves is that, having thought they had buried their child, they now find many years later that it was not quite so. Not only does this reawaken their original grief but, for some parents, it sets back the grieving which had taken place in the interim. If ever we needed a lesson about the importance of differing frames of reference in medicine, surely it has now been provided for us.

These sad events highlight the need for change. We must balance the biological training of our medical and nursing professions with significant training on the psychological aspects in the care of patients and their relatives. We must increase the salience of psychological needs in our hospital systems.

The public must take a greater interest in what actually happens in healthcare and in research. Some years ago in the medical school of the Royal College of Surgeons in Dublin we provided public lectures about medical research following which many of the participants reported that they understood, for the first time, the importance of medical research. Medical schools and hospitals must facilitate communication between those who deliver health services and those who receive them. Partnership should be the watchword. Only in this way will the chasm between the system and those for whose benefit the system operates be bridged.

I do not bear any grudge against the mortuary attendant who responded to my request to cover my father's scars in such an insensitive manner. Having worked in a hospital setting, I was able to see that he was acting as he saw fit within his own frame of reference.

However, 20 years later, I still wish it hadn't happened and I know I will never forget it.

Ciaran O'Boyle is Professor of Psychology at the Medical School of the Royal College of Surgeons in Ireland.