Physician Grief and End of Life Care

Source: NY Times

I often struggle to understand why colleagues fail to address end of life issues or stop aggressive treatments and surgeries when palliative care would be a better course of action.  If one practices inpatient medicine, then end of life care is nearly inevitable.

This perspective, published in the NY Times, sheds light on the impact that death, dying and grief can have on a physician, and in turn on patient care. 

A paper published in the Archives of Internal Medicine qualitatively explored the nature and impact of grief on oncologists. In addition to sadness, crying, loss of sleep and feelings of shame, grief can impact the physician's patient management decisions. Feelings of guilt and failure motivated some oncologists to provide more aggressive care, even when such care was medically futile. Denial and disassociation motivated other oncologists to avoid end of life discussions with the patient and the family, distancing themselves further as the time of death neared. The potential impact on patient care in undeniable, and the study's authors call for physician education on grief and coping not only during training, but as continuing education throughout their careers.

Insightful.