On the emotional connection of medical specialists dealing with death and dying — ASN Events
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On the emotional connection of medical specialists dealing with death and dying (#191)

Sofia C Zambrano 1 2 , Anna Chur-Hansen 1 , Gregory B Crawford 2 3
  1. Discipline of Psychiatry, The University of Adelaide, Adelaide, SA, Australia
  2. Discipline of Medicine, University of Adelaide, Adelaide, SA, Australia
  3. Mary Potter Hospice, Adelaide, SA, Australia

Background: This study reports on the experiences and coping mechanisms of medical specialists when developing an emotional connection with patients in the context of life-threatening illnesses.  Medical specialists from the specialties of intensive care, surgery, oncology, and palliative care participated on one-on-one interviews.

Methodology: Thirty-three semi-structured individual interviews were analysed using Thematic Analysis.  Data saturation was reached with different numbers of participants per specialty: Intensive Care (n=6), Palliative Medicine (n=7), Surgery (n=9), and Oncology (n=11).  These specialties were chosen for their involvement at different stages of the illness trajectory of patients with life-limiting diseases.   

Results: One of the key themes of medical specialists’ experiences with death and dying was the ambivalence about developing emotional connections with patients and families. Advantages of not engaging emotionally with patients were related to preserving objectivity in the decision making process, whilst a perceived disadvantage was the loss of the opportunity to engage in meaningful relationships that could positively influence both patients, families, and the medical specialist.  Finding a balance in the face of ambivalence was a preferred approach and participants employed a variety of coping strategies.

Conclusions: Participants took different positions about the emotional connection that should develop with their dying patients and the patients’ families.  Although there was agreement about finding a balance between objectivity and connection, their strategies to achieving this seem prescribed by individual notions. By sharing perspectives and learning how other colleagues deal with similar issues, there is an opportunity for medical practitioners to develop a well-rounded approach to dealing with death and dying. Understanding and addressing the needs of these professionals, may lead to an improved patient-doctor relationship, and could impact on the care provided at the end of life.