Physician Management of Dying Patients: An Exploration

Abstract

Although there are increasing numbers of disciplined observations and studies about the dying patient, the question remains as to whether they have been read and put into practice. This paper reports on a current study aimed at exploring how physicians actually work with patients suffering from fatal illnesses. Responding to a questionnaire on their methods of managing dying patients were 59 internists, 76 surgeons, 25 gynecologists, 13 general practitioners and 5 psychiatrists. Sixty-six percent of the physicians said they sometimes inform patients of a malignancy, 25 percent said they always tell the patient, and only 9 percent said they never tell the patient. The fact that very few physicians apparently feel justified in saying they never inform a patient about a fatal diagnosis is in itself a modification of previous practice. However, judging from answers to other questions, it is the author's impression that in actual practice many physicians tend to resist informing their patients of the diagnosis in a direct manner and are inclined to be quite selective in informing only those patients described as self-reliant, independent and able to face reality.