The Dying Patient, the Physician, and the Fear of Death

Seravalli, Egilde

doi:10.1056/nejm198812293192609

Cited by 70 publications

(26 citation statements)

References 1 publication

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“…But, he maintains, "If we open ourselves to what can be understood of the particular world of the dying, the feelings that are often present in the sickroom might become bearable." 4 This supposition supports the work of Elisabeth Kübler-Ross. During her extensive research into the dying process, Kübler-Ross found in medical staff "a lot of not only denial and rationalization, but also hostility and some very aggressive behavior.…”

Section: Introductionsupporting

confidence: 70%

“…1 Death may be heralded by phenomena such as visions or apparitions that comfort the dying and prepare them spiritually for death, or for the "crossing over" to a new reality. [2][3][4] However, discussion of these phenomena has largely focused on evidence for the existence of life after death. [5][6][7] Consequently, few satisfactory scientific studies have been carried out to define the frequency and occurrence of DBP.…”

Section: Introductionmentioning

confidence: 99%

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Deathbed phenomena and their effect on a palliative care team: A pilot study

Brayne¹,

Farnham²,

Fenwick

2006

Am J Hosp Palliat Care

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Anecdotal evidence suggests that death may be heralded by deathbed phenomena (DBP) such as visions that comfort the dying and prepare them spiritually for death. Medical practitioners have been slow to recognize DBP, and there has been little research into the spiritual effect that DBP have on caregivers or on how these phenomena influence their work. A pilot study looking into the occurrence of DBP was conducted by the palliative care team at Camden Primary Care Trust. Interviews revealed that patients regularly report these phenomena as an important part of their dying process, and that DBP are far broader than the traditional image of an apparition at the end of the bed. Results of the interviews raise concerns about the lack of education or training to help palliative care teams recognize the wider implications of DBP and deal with difficult questions or situations associated with them. Many DBP may go unreported because of this. Results of this pilot study also suggest that DBP are not drug-induced, and that patients would rather talk to nurses than doctors about their experiences.

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Section: Introductionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Deathbed phenomena and their effect on a palliative care team: A pilot study

Brayne¹,

Farnham²,

Fenwick

2006

Am J Hosp Palliat Care

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“…Death is a regular event, occurring more frequently in ICUs than anywhere else in the hospital [22]. Evidence suggests that physicians are often troubled by personal fears of dying [23] and also that repeated exposure to death during medical training is psychologically traumatic, particularly in the absence of supervision and input from experienced counselors at a senior level [24]. Long work shifts present dozens of decisions about triage and intensive care therapies, each carrying significant and often permanent consequences.…”

Section: Barriersmentioning

confidence: 99%

The intensive care unit family meeting: Making it happen

Pronovost

Bassett

Nelson

2009

Journal of Critical Care

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The intensive care unit (ICU) family meeting is an important forum for discussion about the patient’s condition, prognosis, and care preferences; for listening to the family’s concerns; and for decision making about appropriate goals of treatment. For patients, families, clinicians, and health care systems, the benefits of early and effective communication through these meetings have been clearly established. Yet, evidence suggests that family meetings still fail to occur in a timely way for most patients in ICUs. In this article, we address the “quality gap” between knowledge and practice with respect to regular implementation of family meetings. We first examine factors that may serve as barriers to family meetings. We then share practical strategies that may be helpful in overcoming some of these barriers. Finally, we describe performance improvement initiatives by ICUs in different parts of the country that have achieved striking successes in making family meetings happen.

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“…[7][8][9] Several authors have stated that past experiences, spiritual beliefs, and personal values may affect how one acts in end-of-life circumstances, how physicians communicate with families, and how they handle the information themselves. 2,3,10,11 As J.E.…”

Section: Introductionmentioning

confidence: 99%