When the Physician Says I Have Nothing More To Offer
Moderator -
John R. Stroehlein, M.D., M.D. Anderson Cancer Center
Panelists -
John K. Graham, M.D., MDiv., President and CEO, Institute for Spirituality and Health
James W. Lomax, M.D., Psychiatry Department, Baylor College of Medicine
Michael McClam, M.D., The Menninger Clinic
Most physicians recall being taught in medical school that “the enemy is death” and that the role of the physician is to keep the patient alive. Yet, even before death occurs often the physician must tell a patient and family there is nothing more they have to offer. The doctor may avoid further hospital visits and basically turns patient care over to nurses and chaplains. Then too, many physicians have experienced the loss of a patient on the operating table, from suicide, or by death of iatrogenic origin.
This paper we will address these issues and consider the psychological, emotional and spiritual aspects that impact the physician upon the death of a patient, especially when a patient commits suicide or is lost on the operating table. We will question whether or not physicians should consider their work done when a patient dies or when there is no longer any procedure or active treatment they have to offer. What is the impact on a physician when she must tell a patient there is nothing more medicine has to offer?
As to the patient and family, we will ponder the sense of abandonment and lack of compassion implied when a physician withdraws from a case. We will discuss the anger issues seen in bereavement groups and in the psychotherapist’s office after such withdrawal and upon the perceived loss of a family member due to iatrogenic origin.
The purpose of this panel presentation is principally to invite physicians to recognize their enormous value even when they have nothing curative to offer. The presence of the physician, his or her loving touch and caring voice can help the patient experience a “good death” and the family cope with their loss. Finally, we will discuss the care of the physician who has experienced the loss of a patient under his care.
John R. Stroehlein, M.D., M.D. Anderson Cancer Center
Panelists -
John K. Graham, M.D., MDiv., President and CEO, Institute for Spirituality and Health
James W. Lomax, M.D., Psychiatry Department, Baylor College of Medicine
Michael McClam, M.D., The Menninger Clinic
Most physicians recall being taught in medical school that “the enemy is death” and that the role of the physician is to keep the patient alive. Yet, even before death occurs often the physician must tell a patient and family there is nothing more they have to offer. The doctor may avoid further hospital visits and basically turns patient care over to nurses and chaplains. Then too, many physicians have experienced the loss of a patient on the operating table, from suicide, or by death of iatrogenic origin.
This paper we will address these issues and consider the psychological, emotional and spiritual aspects that impact the physician upon the death of a patient, especially when a patient commits suicide or is lost on the operating table. We will question whether or not physicians should consider their work done when a patient dies or when there is no longer any procedure or active treatment they have to offer. What is the impact on a physician when she must tell a patient there is nothing more medicine has to offer?
As to the patient and family, we will ponder the sense of abandonment and lack of compassion implied when a physician withdraws from a case. We will discuss the anger issues seen in bereavement groups and in the psychotherapist’s office after such withdrawal and upon the perceived loss of a family member due to iatrogenic origin.
The purpose of this panel presentation is principally to invite physicians to recognize their enormous value even when they have nothing curative to offer. The presence of the physician, his or her loving touch and caring voice can help the patient experience a “good death” and the family cope with their loss. Finally, we will discuss the care of the physician who has experienced the loss of a patient under his care.