title: A staff dialogue on caring for a cancer patient who commits suicide: psychosocial issues faced by patients, their families, and caregivers.
abstract: Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery which provides hope to the patient, support to caregivers, and encourages the healing process. The Center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum during which caregivers discuss a specific cancer patient, reflect on the important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from their fellow staff members. The case presented was of a 31-year-old man who developed adenocarcinoma of the lung with painful bone metastases. His tumor was unresponsive to treatment and he subsequently committed suicide by shooting himself. The verbatim and subsequent discussion raised a number of issues. Staff were devastated by the violent way that he ended his life. They questioned whether more could have been done to prevent this outcome, yet acknowledged that it mirrored the way he had lived, and were able to discuss the values by which we live and die. Some, but not all, felt that the patient had the right to choose how and when to end his life.
authors.affiliation: Hematology-Oncology Department, Massachusetts General Hospital Cancer Center, Boston, Massachusetts 02114-2617, USA.
authors.forename: E M
authors.initials: EM
authors.lastname: O'Shea
authors.forename: K C
authors.initials: KC
authors.lastname: Lintz
authors.forename: R T
authors.initials: RT
authors.lastname: Penson
authors.forename: M V
authors.initials: MV
authors.lastname: Seiden
authors.forename: B A
authors.initials: BA
authors.lastname: Chabner
authors.forename: T J
authors.initials: TJ
authors.lastname: Lynch
mesh_terms: D000230:Adenocarcinoma / Q000523:psychology* / Q000556:secondary; D000328:Adult; D001293:Attitude to Death; D017028:Caregivers / Q000523:psychology*; D006801:Humans; D008159:Lumbar Vertebrae; D008175:Lung Neoplasms / Q000473:pathology / Q000523:psychology*; D008297:Male; D010146:Pain / Q000188:drug therapy / Q000523:psychology; D010551:Personality; D013125:Spinal Neoplasms / Q000523:psychology* / Q000556:secondary; D018454:Spouses / Q000523:psychology; D013405:Suicide / Q000523:psychology*; D017236:Suicide, Assisted / Q000523:psychology; D013904:Thoracic Vertebrae