By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    learn to recognize and treat yeast infections
    Most Commonly Asked Questions About Yeast Infections
    November 17, 2021
    Advanced lung cancer diagnosis systems used by doctors
    Advanced Lung Cancer Diagnosis Systems Used by Doctors
    March 6, 2022
    The Top Benefits of a Wearable Blood Pressure Monitor Watch
    The Top Benefits of a Wearable Blood Pressure Monitor Watch
    June 13, 2022
    Latest News
    Beyond Nutrition: Everyday Foods That Support Whole-Body Health
    June 15, 2025
    The Wide-Ranging Benefits of Magnesium Supplements
    June 11, 2025
    The Best Home Remedies for Migraines
    June 5, 2025
    The Hidden Impact Of Stress On Your Body’s Alignment And Balance
    May 22, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Chronic Disease Prevention Remains Top Priority
    September 9, 2017
    Worst Editorial of the Week Award
    September 13, 2017
    Are the Uninsured Getting a Free Ride?
    May 16, 2011
    Latest News
    Let Your Lawyer Handle the Work Before You Pay Medical Costs
    July 6, 2025
    Top HIPAA-Compliant Messaging Apps for Healthcare Teams
    June 25, 2025
    When Healthcare Ends, the Legal Process Begins: What Families Should Know About Probate and Medical Estates
    June 20, 2025
    Preventing Contamination In Healthcare Facilities Starts With Hygiene
    June 15, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: End of Life Care: Advice for Physicians Dealing with Families
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Wellness > Home Health > End of Life Care: Advice for Physicians Dealing with Families
Home HealthHospital Administration

End of Life Care: Advice for Physicians Dealing with Families

DavidEWilliams
DavidEWilliams
Share
5 Min Read
SHARE

Writing in Today’s Hospitalist, Dr. Stella Fitzgibbons offers specific and useful advice to physicians who have to deal with the wishes of a family when a patient can longer speak for him or herself. I’m confident that her approach will yield constructive results in most situations, but I’m uncomfortable with the shortage of empathy and reflectiveness that the article ultimately conveys.

The scenario she introduces is as follows:

Writing in Today’s Hospitalist, Dr. Stella Fitzgibbons offers specific and useful advice to physicians who have to deal with the wishes of a family when a patient can longer speak for him or herself. I’m confident that her approach will yield constructive results in most situations, but I’m uncomfortable with the shortage of empathy and reflectiveness that the article ultimately conveys.

The scenario she introduces is as follows:

More Read

Healthcare Provider Pain Points
8 Healthcare Provider Pain Points
Ethical Decisions: Strong Leadership and Effective Planning Are Key
2015 CPT Coding Changes and Your Radiology Practice
Engaging Consumers for Improved Cost, Quality and Outcomes
Hospital Marketing and Ebola: Communication and Education Needed

[W]hat about a patient who can no longer speak for himself—and family members who either seem unrealistic about the effectiveness of medical treatment or actually refuse to honor his wishes? What about a doctor’s duty to relieve suffering and not provide treatment the patient wouldn’t want or that does him no good?

To summarize, here are the tactics Fitzgibbons recommends:

  • Be sure all the doctors seeing the patient are saying the same thing –so that a doc who doesn’t like to give bad news doesn’t inadvertently give the family the idea that a cure is possible
  • Get records from prior physicians –since families may transfer patients from hospital to hospital until they hear what they want
  • Present facts and show them CTs. “Make it clear that the patient’s doctors know what is wrong and are not just speculating”
  • Bring in a neurologist you trust so “the family can’t claim that he’s unqualified to talk about the prognosis”
  • Find a chaplain who will be on your side
  • Seek help from legal staff so you can ignore the family’s wishes and use the patient’s advance directive
  • Persuade the patient that their “advisor” is less qualified than yours and that their stories of relatives who recovered are irrelevant
  • If you think they are acting against the patient’s interests for their own gain, e.g., “they have been paying their own rent with his disability check” –then let the know you’re aware of it
  • Stick to your principles since you know you’re doing the right thing for your patient
I don’t know the author and have no reason at all to distrust her motives. But I do get nervous about her level of certainty. In particular:
  • It concerns me that all the focus on bringing in other parties is about getting them to team up with her and reinforce her opinion. She doesn’t once suggest asking someone to take a fresh look clinically or to help her see things from the family’s perspective
  • Physicians are notoriously poor at predicting how long someone is going to live. It’s unreasonable to expect a family to trust them on this
  • A lot of physicians don’t like hopeless cases or “difficult” patients or families. Consciously or sub-consciously they may be ready to move on to the next case –of which there are a seemingly endlessly supply. Meanwhile, the family may not be quite so ready to let go of grandpa
  • The issue with the advance directive is extremely tricky. On the one hand it represents the patient’s wishes –but those wishes were set out at a point in time different from the present, when things may have looked different. It’s possible that the physician can better interpret the patient’s wishes than the family, but both have biases
I don’t totally discount Fitzgibbons advice, but I’d add a few doses of empathy, humility and self-reflection to the mix.


TAGGED:end of life decision
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

9 Lifestyle Tweaks That Can Add Years to Your Life
9 Healthcare Lifestyle Tweaks That can Add Years to Your Life
lifestyle
July 11, 2025
car accident lawsuit
Let Your Lawyer Handle the Work Before You Pay Medical Costs
Policy & Law
July 6, 2025
women dental care
What Is a Smile Makeover and How Much Does It Cost?
Dental health
June 30, 2025
HIPAA-Compliant Messaging Apps
Top HIPAA-Compliant Messaging Apps for Healthcare Teams
Global Healthcare Policy & Law Technology
June 25, 2025

You Might also Like

EHR and meaningful use
Hospital Administration

How Safe Is Your Hospital?

April 20, 2011
Hospital Administration

How To Improve Your Experience At The Doctor’s Office

August 7, 2022

Adapting to Millennials with Health Care Technology

December 10, 2014
BI analytics HIS
BusinessFinanceHospital AdministrationRadiologySpecialties

Using Business Intelligence and Analytics for Radiology Billing

May 11, 2013
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?