Clinicians seem to be reluctant to engage in end of life discussions, Elizabeth Tracey reports


Among doctors who specialize in cancer treatment, only very few broached the subject of end of life decisions with their patients, even when an analysis of recordings of their encounters pointed toward an opportunity to do so, a recent study found. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, examines the data.

Nelson: The trial had something like 141 patients talking and 31 providers at 2 academic centers. When they looked back at 423 encounters, and found that only 5% or 21 involved formal end of life discussions. They did believe that 38% of the recordings that they listened to provided an opportunity for an end of life discussion that may have been missed.  :24

Nelson says in his own practice he begins a discussion of end of life preferences at the very first visit, before such decisions really must be made. He advises patients to bring up the issue themselves if their physician doesn’t do so, so that their wishes are known. At Johns Hopkins, I’m Elizabeth Tracey.