The decision to engage in end-of-life discussions: a structured approach for doctors in training.
Engaging in end-of-life discussions is a major source of anxiety for doctors in training. The authors propose the use of a decision-making model to assist trainees and their clinical supervisors in such situations. Divided into' 'patient-centred' and 'physician-centred' components, the model ensures that the following aspects are analysed: patient and family safety, patient and family choice, physician competence and physician comfort. A real but historical end-of-life scenario is presented to a foundation year 1 doctor, and the particular risks of engaging in a discussion are subsequently clarified with reference to each of the model's components.
St. Thomas' Hospital, London.
Rory
R
Conn
Philip A
PA
Berry
D001291:Attitude of Health Personnel; D001293:Attitude to Death; D002983:Clinical Competence; D003144:Communication Barriers; D003220:Conflict, Psychological; D003657:Decision Making; D004503:Education, Medical, Graduate; D005066:Euthanasia, Passive; D005190:Family / Q000523:psychology; D006801:Humans; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D013727:Terminal Care