Giving bad news is never easy. Telling someone that they are terminally ill is exceptionally challenging. A study in the Journal of Oncology Practice revealed that delivering end of life news to patients is one of the most stressful parts of their jobs as oncologists. Remarkably, training in how to effectively communicate with patients and protocols as to what to cover is largely absent.
What makes end of life discussions so hard
There are several reasons why it is difficult to have an end of life discussion with a patient. Physicians may have difficulty talking to patients because of their own personal discomfort with the subject of dying and death. Many oncologists focus on shifting the focus of treatment to palliation when discussing terminal cancers such as mesothelioma. The problem when discussing a terminal diagnosis, unlike other clinical outcomes, is that the impact of the diagnosis is far greater.
Because the ultimate prognosis is death, a broader discussion needs to be had with the patient both about the dying process and death.
Effective communication for a terminal diagnosis
As oncologists, your patients rely on you for much more than your expertise with the treatment of tumors. Your patients count on your ability to be part counselors, advising them on what to expect and what their options are when confronted with a terminal diagnosis. The following are some strategies for effectively delivering a terminal diagnosis:
- Practice — Practice what you will say and take time to be thoughtful about your words. It may be helpful to listen or discuss with other physicians for ideas and guidance.
- Prepare — Arrange for a comfortable place to have a discussion with your patient. Make sure you not only bring clinical information, including test results and information about the what to expect, but you also gather important resources, such as names of therapists who specialize in end-of-life counseling and estate planning attorneys, but also mesothelioma compensation attorneys. Mesothelioma patients are entitled to a broad range of benefits. Mesothelioma attorneys are invaluable for not only the patients but their families. They can advise your patients on their full range of options.
- Be direct and compassionate — When meeting with your patient, be open and direct in your diagnosis, avoiding clinical terms, but being compassionate. Allow your patient time to absorb the news. Patient reactions will range from shock to anger to despair. Be supportive and empathetic to your patient and his or her family. Give them time to react before providing them with resources or scheduling follow-up discussions with patients.
- Schedule follow-up meetings — Subsequent meetings with a patient will be critical to evaluate their emotional condition as well as their physical condition. Patients who have yet met with a psychologist or mesothelioma attorney should be encouraged to do so to help them maintain a quality of life as they are dying and to prepare for their death.
Self-care for oncologists
Oncologists will need to monitor their own emotions throughout this process. Many oncologists benefit from processing their emotions with family members (while observing patient confidentiality), other oncologists and therapists.