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Is it OK to attend your patients’ funerals?

 

She’s a long-time patient, and over the years, your professional relationship has developed a certain personal dimension. You treat her in her decline, refer her to palliative care and she passes away in a hospice. Should you attend her funeral? Or does this cross a professional line? It’s a delicate question that hasn’t been much examined in the medical literature.

In a recent opinion piece, a Melbourne-based anaesthetist looked back at her management of a patient with pancreatic cancer, who she helped “navigate the tortuous terrain of mortal illness”. Dr Katrina Barber found herself a first-hand witness to the “raw emotion that spills over with the coming of death”.

“I wondered whether it would be appropriate to attend the funeral of that patient. Even after the worst had happened, I didn’t have the answer.”

Although Dr Barber ultimately did go to the funeral, she points out that “the right course of action for one doctor may not be the correct course for another.”

She notes that while the presence of a doctor may offer comfort to the patient’s family, it could also “stir up problems rather than bring solace”. It could invite anger or recriminations from the family who may blame the clinician for the loss of the patient’s life. There may also be wider-ranging implications concerning patient confidentiality.

Given that this is a dilemma likely to be faced by most doctors, surprisingly little research has been done on doctors attending patient funerals. But one of the only recent studies on the subject is Australian. Researchers from the University of Adelaide carried out an anonymous survey of 437 doctors and found that most had attended at least one patient funeral. GPs were the most likely to have attended a funeral (71%), while surgeons (52%) and ICU specialists (22%) were the least likely.

Female doctors were more likely to have attended a patient funeral, and they were also more likely to do so out of grief for the patient’s death rather than a sense of obligation. Women were also more open to crying at a funeral and discussing going to funerals with their colleagues. Young male doctors were the least likely to attend.

Study co-author Associate Professor Greg Crawford, who works in palliative medicine, said the benefits of attending a patient funeral may be twofold: “It’s a practice that may help physicians deal with their emotions after a patient dies, and in turn it can also be of comfort for the patient’s family,” he said.

But he said there were differing views in medicine about its acceptability, with some doctors feeling it to be unprofessional and other feeling that their colleagues might disapprove of them.

“The medical community should ask itself whether funeral attendance needs to – and can – be addressed more openly, whether death and dying should be discussed more candidly among health professionals, and what effects these discussions may have on job satisfaction and on the mental health of medical practitioners,” the study authors wrote.