Doctors’ need more compassion

Doctors’ need more compassion in delivery of prognosis to dying patients

A leading researcher and author on the psychological needs of dying people, Professor David Kuhl, says doctors need to show more compassion when they pass on the news to patients of their terminal condition.

Professor Kuhl, an associate Professor in the Faculty of Medicine at the University of British Columbia, is in Auckland this week to present the seminar “What Dying People Want” at The University of Auckland’s School of Population Health.

He has carried out extensive research into terminal illness, interviewing hundreds of patients with terminal cancer and Aids and has written a book “What Dying People Want: Practical Wisdom for the End of Life”. He has worked for many years in palliative care.

“We know a lot about managing physical pain but less about the psychological and spiritual suffering of the terminally ill,” Professor Kuhl says.

One of the key findings of his research was that the clinical way in which so many people were told that their illness was terminal made their suffering worse.

“Many of those I spoke to said the pain caused by the way the news was delivered, was worse than the pain of the illness itself.”

“I learnt that the doctor-patient relationship becomes hugely important during those final months and in that context doctors need to enhance their communication skills.”

Following this finding, Professor Kuhl redirected his research and teaching from palliative care to working with those who deal with death and the dying regularly in their work, such as medical professionals, emergency service personnel and armed forces.

“I wanted to understand how those who choose to undertake a role to diminish suffering can maintain and continue to express their compassion, when dealing constantly with tragedy.”

“I am looking at the cost to people of being constantly exposed to trauma and tragedy, and ways to help prevent the “compassion fatigue” they can suffer,” he says. “The cynicism often exhibited in these situations is a hallmark of the trauma these people are suffering themselves.”

Amongst those he is working with are armed forces personnel returning from combat and peacekeeping duties.

Professor Kuhl’s initial research was funded by the Soros Foundation’s Project on Death in America.

He says for many dying people the time becomes one of self-reflection and life review, and for seeking closer connections with people around them.

“This makes the patient doctor relationship especially important.”

Professor Kuhl’s lecture will be held on 8 March from 12.30 to 1.30 at The University of Auckland School of Population Health. In addition, he is available for interviews during his visit to New Zealand. He can be contacted on 09 378 8050 or dkuhl@providencehealth.dc.ca.

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