Not in medical textbooks: How doctors find a way to tell fam
Across hospitals in India, deaths of patients have led to altercations – often violent – between patients’ families and doctors.

One of the most overlooked aspects of medicine at public hospitals across India is the communication of the news of death. Unfortunately, there is nothing in the medical education curriculum about how to tell a patient’s family, friends and attendants that he or she has died. There is little to prepare doctors for the various difficulties they may face in conveying such news. Across the country, the news of death has increasingly led to violence against doctors.

“On my second or third day of residency, I had to declare a death at 5 am on my own,” said Dr. Mrunal Awalekar, a surgical resident at Government Medical College at Aurangabad. “Nobody told me how to do it. I didn’t know what to say.”

Although declaring a patient dead is a doctor’s medico-legal responsibility, most doctors learn to perform this crucial and tricky task – one that is fraught with uncertainty and emotion – by observation.

Most doctors are emphatic that when a patient’s condition begins to deteriorate, they update the family at regular intervals and counsel them about the imminent possibility of death, without giving false hope.

Doctors sometimes delay the announcement of death out of a desire to avoid shocking the family and from fear of violent reaction. Awalekar said, “Sometimes, when I am called to a patient’s bedside, he has already passed away. But I won’t declare death immediately. I’ll perform CPR for 15-20 minutes, then declare death.”

Who tells the family?

“It is one of the paradoxes of medicine: the more junior you are, the more often you have to declare death,” says Jarin Noronha, an oncosurgeon who recently finished training at Mumbai’s Tata Memorial Hospital. The unwelcome task of declaring death almost always falls to a first-year or second-year resident, who is often the only doctor present in the ward or ICU at the time of death. Unless the death occurs before the morning rounds of wards by senior doctors or a patient is a high-profile case, senior doctors are almost never involved.

Doctors at some public hospitals take the initiative themselves to make sure that the family hears the news of death from a doctor with whom they are most comfortable.

Read about how is the news broken and more here:
Dr. T●●●●z H●●●●●●i and 5 others like this2 shares
Dr. P●●●●●p K●●●●●●i
Dr. P●●●●●p K●●●●●●i Medicine
Communication in terminal phase of life needs to be taught to undergraduate students.
Aug 8, 2018Like1
V●●●●h s●●●h
v●●●●h s●●●h General Medicine
"disclosure of bad news " is given in Harrison 1st volume in initial chapter(15th edition).But it is in the view of europian and American context,not indian.
Aug 8, 2018Like3
Dr. U●●●h G●●●●r
Dr. U●●●h G●●●●r Palliative Medicine
Daily communication with relatives. & explaining about the condition of the patient from our end (pro-active) on daily basis-Helps
Aug 8, 2018Like