How Physicians Deal With Their Own Impending Death

The physician as patient in palliative care: A retrospective case-note audit

“…[1][2][3] Compounding factors such as involvement of multiple specialists, lack of a coordinating clinician, prolongation of curative treatments, resistance to palliative care input and barriers to discussing psychosocial needs may lead to suboptimal and late access to palliative care. 1,2,4 Physician-patients may also bypass standard access protocols to medical services which may compromise the ability of palliative care teams to maintain appropriate professional boundaries. 2,5 Examples of this include physician-patients engaging in 'curbside consultations' and utilising informal means of contacting their palliative care physician such as direct phone calls, e-mails or meeting at social events.…”

“…1,3,4,7,8 Medical knowledge can be psychologically challenging: the rational understanding of the illness may be discordant with their emotions and behaviours. 3 Physician-patients may suffer from increased anxiety or fear 1,4 due to their awareness of adverse effects, complications and limitations of the treatments provided, 1 or due to the likely avoidance of psychosocial wellbeing discussions. 2 Behaviourally, the need to remain in control can translate into self-doctoring behaviours by accessing own test results, overly directing consultations or bypassing referral systems.…”

“…2,6 The dying physician must deal with personal and professional difficulties related to their dual role as a patient and as a physician. 1,3,4,7,8 Medical knowledge can be psychologically challenging: the rational understanding of the illness may be discordant with their emotions and behaviours. 3 Physician-patients may suffer from increased anxiety or fear 1,4 due to their awareness of adverse effects, complications and limitations of the treatments provided, 1 or due to the likely avoidance of psychosocial wellbeing discussions.…”

An Exploration of Relative Health Stock in Advanced Cancer Patients

“…Some clinicians, biostatisticians, and health services researchers have described cancer patients' decision to take part in phase I trials as risk-seeking behavior. [11][12][13][14] However, a recent review disputes this commonly held view by suggesting that phase I trials have acceptable risk-benefit ratios. 15 One possible explanation of some cancer patients' willingness to participate in phase I clinical trials is that they do not correctly perceive the potential benefits and toxicities associated with treatment.…”