Doctors Don’t Talk About End of Life Care

The January 11 online edition of Cancer reveals that there is general lack of communication between physicians and terminally ill patients regarding end of life care.

As reported in Health Day, a national sample of almost 4,100 physicians who treat cancer patients was taken. Physicians were given a hypothetical example of a cancer patient with four to six months to live but who was still feeling well.

65 percent said they would discuss a prognosis. Only 26 percent said they would discuss hospice; 21 percent said they would discuss where the patient would like to die; and only 44 percent said they would discuss resuscitation preferences. Current medical guidelines recommend having end-of-life discussions when patients have less than a year to live.

There are many reasons why doctors aren’t having these discussions as often as they should, said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society. The conversations can be time consuming and emotionally wrought. And estimating how long someone has to live is an inexact science. Patients can differ in how much they want to be told and families can be another complicating factor urging the loved one to keep fighting.

Younger physicians were more likely than older physicians to have end-of-life discussions with patients, possibly indicating that current medical training places more emphasis on palliative care.

If doctors don’t bring up end-of-life issues, patients need to bring it up with their physicians, making sure their wishes are known, said lead study author Dr. Nancy Keating, associate professor of medicine and health care policy at Brigham and Women’s Hospital and Harvard Medical School.

And that would be my recommendation as well. People need to be aggressive in seeking answers to their healthcare needs.