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P-42 Euphemisms when describing death and dying in specialist palliative care: an observational survey
  1. Jon Choy1,
  2. Andrew Thorns2 and
  3. Charlotte Brigden2
  1. 1Maidstone Hospital, Maidstone, UK
  2. 2Pilgrims Hospices in East Kent, Canterbury, UK


Background Euphemisms are frequently used to replace the words ‘death’ and ‘dying’ in the general population as well as within healthcare settings. Their use risks unclear communication leading to complaints in healthcare sectors ( Magnus, Fox, Elster, et al., 2015). The General Medical Council states: ‘you must do your best to explain clinical issues in a way the person can understand’(General Medical Council. Treatment and care towards the end of life: working with the principles and decision-making models).

Encouraging people to openly talk about death and dying enables them to make informed decisions about their future health care and treatment (Lakasing, 2014). Research has shown that patients and caregivers prefer communication using direct language, avoiding euphemisms (Collins, McLachlan, & Philip, 2018).

Aim To observe the use of the ‘d-words’ (death/dying/died) compared to euphemisms in a hospice multi-disciplinary team.

Methods A prospective, observational survey of language used in multi-disciplinary meetings over a two-week period across three hospices. Participants were blinded to data collection which was performed anonymously by one staff member on each site. The proportion of euphemisms were compared to ‘d-words’.

Results Multidisciplinary teams were more likely to use the ‘d words’ (76%; n: 241) than euphemisms (24%; n: 75). There was variation between the hospices: 39% (n:50) compared with 17% (n:20) and 7% (n:5). This could be due to differences in staff or interpretation during data collection.

Conclusion Considering specialists in palliative care are heavily involved in discussions around death, it is unclear why 24% would opt to use euphemisms. Does this suggest fear within some professionals of talking about death openly? Are staff who use euphemisms amongst themselves more likely to use them with patients? Or by their use are staff exhibiting a sensitive approach to difficult issues? Further investigation is required to evaluate the use of euphemisms with patients and relatives and to compare across other healthcare settings.

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