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BMJ Support Palliat Care doi:10.1136/bmjspcare-2012-000326
  • Research

The lived experience of physicians dealing with patient death

  1. Paul Richard Whitehead
  1. 1Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
  2. 2Centre for Practitioner Renewal, Providence Health Care, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Paul Richard Whitehead, Department of Family Practice, Faculty of Medicine, University of British Columbia, 320–5950 University Boulevard, Vancouver, British Columbia, Canada V6T 1Z3; pwhitehead{at}providencehealth.bc.ca

Abstract

Background A growing body of research indicates that physicians suffer high levels of stress, depression and burnout. Related literature has found that physician stress can negatively impact patient care. This study builds upon previous research that found some dying patients experienced ‘iatrogenic suffering’ caused by the way physicians communicated with them regarding terminal diagnoses and palliative treatment. The goal of this research was to explore physicians’ experiences of dealing with patient death in order to understand how such experiences affect them and their communication with patients.

Methods This study used qualitative methods to conduct and analyse 10 individual, semistructured interviews with senior physicians from several specialty areas at a large, tertiary care hospital. The resulting themes were validated using member checks and expert review.

Results This article presents five essential themes that provide a concise description of the lived experience of patient death for these physicians. Interpretation: These themes indicate that physicians can experience very strong and lasting emotional reactions to some patient deaths, and also that patient death can elicit intense experiences related to professional responsibility and competence. A key finding is the description of a complex process of managing the balance between personal and professional reactions in the face of patient death. The implication is that difficulties negotiating this balance may lead to unintended lapses in compassion and suboptimal outcomes in patient care.

  • Received 1 August 2012.
  • Revision received 17 October 2012.
  • Accepted 29 October 2012.
  • Published Online First 30 November 2012

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