Open Discussions Best for End-of-Life Care

A study from Open Medicine surveys 440 patients with terminal illness and 160 family members from five Canadian hospitals. This article includes an interview with one of the researchers:

Only 18 per cent of patients and 30 per cent of families said they discussed the prognosis with their doctors,even among very sick patients with more than 50 per cent probability of death within the next few months,the study found.

This has to change, said Heyland, professor of medicine at Queen's and research director at the clinical evaluation research unit at Kingston General Hospital.

Patients with terminal illness and their families who had open and honest discussions with their doctors were more satisfied with the level of care given and had time to prepare for the impending death.

. . .

"Some are just uncomfortable talking about death and dying," Heyland said, adding that it can be time-consuming for doctors with many other patients to see.

Social workers and ethicists can help by getting the conversation going so patients and their families are better prepared for making critical decisions when they meet with a doctor, Heyland said. He warned, however, that some patients and their families don't want to have end-of-life discussions with a doctor.

In those cases, he said, having such a conversation can have the opposite effect and make matters worse - as can a poorly handled discussion.