Bioethics Blogs

Which Doctor Should Carry Out the End of Life Conversation?

Yesterday, Steve Phillips echoed my support for Dr. Atul Gawande’s book, Being Mortal.  One of Dr. Gawande’s key points is how difficult it can be for doctors to talk with their patients about care at the end of life, when the doctor cannot “fix” the problem.  Steve also raised the difficulty of these discussions in his January 28 post on this blog.

This past Tuesday, PBS’s Frontline installment was entitled “Being Mortal,” and was done by Dr. Gawande.  He followed several terminally ill people’s conversations with their doctors about their last days, and separately interviewed the doctors about their difficulties in carrying on the conversations.  It can be viewed online, at the website for Frontline.  If you watch it, I think you will agree about the nobility of all appearing on the program—most notably the patients and their relatives.

And now, the New England Journal of Medicine posts a “Clinical Decisions” exercise, in which it presents a case vignette for a 59 year-old woman with advanced breast cancer, and asks, “who [that is, which doctor] should discuss end-of-life care with this patient”—her primary care physician, her oncologist, or a palliative care specialist?  There are thoughtful essays supporting each choice, and an opportunity for physician-readers, anyway, to vote for one, and to post comments in support of their vote. 

Maybe worth checking out, if you have access.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.