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Doctors may need support to cope with patient death

September 13, 2007

Doctors could benefit from support to help them cope with the trauma of patient death, says a psychologist speaking at the Death, dying & disposal conference organised by the University of Bath today.

In a preliminary study, Dr Elaine Kasket from London Metropolitan University carried out detailed interviews with eight US physicians about their experiences of death. Half of those she spoke to wept as they recounted stories of traumatic death they had experienced as physicians, even though some of these events had occurred as much as 30 years ago.

"There is an unwritten rule for doctors that suggests it is not wise or possible for them to feel emotions over a patient's death because there is always another patient to help," said Dr Kasket.

"Whilst this detachment might help when presented with a patient with a severe injury, I question how well it serves them in the longer term.

"This emotional detachment is socially ingrained through medical school, and the cultures in both the UK and US medical establishments would see a physician's emotional response to death as a sign of weakness and even incompetence.

"It feeds into this popular image of the physician as some kind of superhuman ultimate rescuer of human life; unable to do his or her job if they give in to or even acknowledge their emotions.

"The reality is that doctors, and other medical professionals, regularly encounter violent human death, and medical culture does not tend to acknowledge the possibility that they need support to help them deal with any grief and emotional disturbance they may experience.

"There are countless examples of doctors being cold and dispassionate as they tell family members of the death of a loved one, and the physician's own defensiveness and anxiety could well be part of this communication problem.

"It may be that creating a shell is actually the best way of coping with the trauma of the job, but I'm not convinced of that. It is certainly not the case for psychologists working with cancer patients who feel unable to work well if they do not process their emotions.

"Medical training instils and re-enforces this approach to dealing with death.

"Also there needs to be a sea change in medical culture to make support available, and for it not to be stigmatised, to help them cope with grief, depression, despair or sadness."

The eighth international conference on Death, dying & disposal is organised by the Centre for Death & Society and ICIA at the University of Bath and takes place from 12-15 September 2007. More than 200 academics and practitioners from around the world will gather to discuss the latest research on issues relating to the social aspects of death and dying.

University of Bath