Physicians delay end-of-life talks to keep hope alive

Physicians tend to procrastinate on end-of-life talks with terminally ill patients, sometimes to the point where no other treatment options are available, a recent survey of doctors nationwide indicates, according to HealthDay

At present, guidelines recommend that doctors initiate such talks with patients once they have less than one year to live. Of the 4,100 doctors surveyed however, only 21 percent said they would actually talk with a patient about where they would like to die, while 26 percent said they would talk about hospice with a patient. The questions were based on a hypothetical situation in which a cancer patient had four to six months left to live but was "still feeling well." 

According to Dr. Ken Lichtenfield, the deputy chief medical officer of the American Cancer Society, reasons for such delays can range from the conversations being "time consuming" to a desire to keep hope alive for patients. 

"Doctors are trained to save lives," Lichtenfield said. "They want to believe, and the patient wants to believe, they are going to be different from the average." 

Dr. Nancy Keating, associate professor of medicine and healthcare policy at Brigham and Women's Hospital and Harvard Medical School and the study's lead author, believes that regardless of the reasoning, patients should be made aware of what's going on around them. For example, Keating points out that chemotherapy use often increases at the end of life, even though it's not likely to have much of an effect. 

"Everybody deserves to hear a little about what the options are and how aggressive they want treatments to be," Keating said. 

To learn more about this trend:
- read the full HealthDay article