Doctors Who Abandon Dying Patients and Their Families...

Submitted by SadInAmerica on Tue, 03/10/2009 - 3:45am.

Doctors spend years learning how to heal, but most are fairly ignorant about how to act toward patients when they run out of treatments, suggests a study today.

Often, once doctors refer a patient to hospice care, they end all contact, leaving patients and their families feeling abandoned, says lead author Anthony Back, a professor of medicine at the University of Washington.

"I think patients should expect more," says Back, an oncologist.

"I don't think it's OK for them to talk to the doctor about hospice and never hear from the doctor again," he adds. "I think it just makes that whole process harder."

Back and his co-authors interviewed 31 doctors and 55 of their patients, all of whom had incurable cancer or advanced chronic obstructive pulmonary disease and were expected to die within a year.

The researchers also interviewed 36 family caregivers and 25 nurses. Interviews took place at the year-long study's beginning, middle and end.

Although the study wasn't originally designed to look at abandonment by doctors, participants kept raising that issue, the authors write in the Archives of Internal Medicine.

"I think it's important that you still have that contact with them even though there isn't anything they can do to make you better," one patient told the researchers. "But they can hold my hand, so to speak, to the very end."

Family caregivers usually feel as close to the doctor as the patient does, Back notes.

BETTER LIFE: Doctors' empathy improved seeing CT patients' photos

One family member said that a call from the doctor after her loved one's death "showed me that he cared and that she just wasn't … a patient that he treated."

Sean Morrison, a palliative care doctor at New York's Mount Sinai Medical Center, calls Back a pioneer in training doctors how to have difficult end-of-life conversations with patients.

Although doctors might not always realize it, Morrison says, "they need to have closure … just as much as patients and families do."

When Kathy Aho's husband, Mitch, began receiving hospice care last June, the couple had Back's pager and home numbers. "Whatever you needed, Tony was there," recalls Aho, a nurse at the University of Washington.

Mitch Aho, 55, died in October after an eight-year battle with islet cell cancer, and Back called twice to see how she was doing, says Kathy Aho, who still gets e-mails from his staff.

She can't understand doctors who drop dying patients. "To abandon your patient emotionally at the end? That's brutal."

Rita Rubin - March 9, 2009 - source USAToday

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Submitted by SadInAmerica on Tue, 03/10/2009 - 3:45am.