Patient end-of-life choices limited by physician outlook


Quality of life and care for terminally ill patients is often dictated by the specific options and treatment recommendations offered by their doctors, according to a study published in the International Journal of Gynecological Cancer.

900 members of the Society of Gynecologic Oncologists were surveyed to determine their opinions and decisions regarding end-of-life choices and patients with incurable diseases. Results revealed that a physician's level of comfort in discussing death, his medical ethics training, and his religious affiliations were pertinent factors affecting the options presented to terminally ill patients.

The physicians surveyed represent a unique group, as they treat patients both surgically and medically. Their influence in the conversations between patient and doctor regarding life-sustaining decisions are significant, affecting a patient's last days with family or hope from further treatments that may or may not be futile. Findings highlight "straight talk" and "compassion" as some of the key aspects in these conversations. However, of those surveyed, "8% of physicians would avoid telling a patient that they have a terminal condition" while only "75% would disclose to patients with inoperable cervical cancer before initiating treatment, that their disease is incurable."

"It is important to recognize opportunities to help physicians to speak about their concerns and to improve conversations about breaking bad news," says Dr. Lois Ramondetta, author of the published study. A team approach involving nurses, clergy, physicians and psychiatrists, educational workshops and taped practice sessions were among those methods favored to help change current approaches in improving patient awareness and options.

Source: Eurekalert & others

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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