Whose Death Is It, Anyway

Elisabeth Hansot; Thomas A. Raffin; Timothy Gilligan

doi:10.7326/0003-4819-126-7-199704010-00028

Letters |1 April 1997

Whose Death Is It, Anyway

Elisabeth Hansot, PhD; Thomas A. Raffin, MD; Timothy Gilligan, MD

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IN RESPONSE:

We appreciate the responses to our articles. We have received numerous testimonials from people who have had unfortunate experiences similar to Dr. Hansot's. Several of the preceding letters show the enormous difficulty patients and their families sometimes face when trying to have their wishes to limit care respected. Dr. Lena's account of a patient's family and friends having to become personally involved in extubating the patient must be disturbing to any physician. Dr. Ringel asks the key question, How do we prevent such unhappy scenarios in the future?

First, physicians must accept the possibility that patients may not want aggressive care. Dr. Salon argues that the physician's responsibility includes assessing not only the patient's condition but also the patient's wishes. To make such assessments requires time: time to communicate and time to establish a relationship. It also requires that physicians value the physician–patient relationship. Levinson and Roter [1] found that physicians who considered the psychosocial aspects of patient care to be important had better communication skills. Dr. Rousseau asserts that it is essential to teach communication skills to physicians-in-training, and encouraging evidence shows that education can improve communication skills [2, 3].

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Letters |1 April 1997

Whose Death Is It, Anyway

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Letters |1 April 1997

Whose Death Is It, Anyway

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