Establishing a bond makes difficult discussions easier
Ethics Forum. Feb. 7, 2005.
Scenario: How can you best talk to your patients about end-of-life care?
How should physicians introduce organ donation and end-of-life discussions with their patients and/or their families?
Reply:
Knowing how to prepare patients for the end of life is one of the most important communication skills for a physician to have. It is a task all physicians should be able to do with confidence. Yet according to a survey of physicians and medical students published in the August 2004 issue of Academic Medicine, many of us are uncomfortable with the topic.
This survey also showed that medical students and residents received little education about end-of-life care, and many faculty feel unprepared to teach the topic. In recent years, experts in the fields of palliative and hospice medicine have devoted time and energy to developing helpful approaches to these discussions, and many medical schools, residencies and fellowships have incorporated these topics into the curriculum.
At Emory University School of Medicine in Atlanta, we have developed an approach to discussing end-of-life care that focuses on two key guidelines. The first is that communication techniques, such as listening and expressing empathy, are critical to establishing a bond with a patient so that difficult topics such as death and dying can be discussed openly. The second is that conversations about any specific intervention, such as surgery, code status or plans for hospice, should be made only after a discussion of the patient's overall goals for care.
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