Barry Ashpole Media Watch (#465)

Barry Ashpole Media Watch

The latest issue of  Media Watch, compiled and annotated by Barry R. Ashpole (Ontario, Canada) can now be downloaded here. More reports can be found at IPCRC.NET

Article highlighted to be of particular interest:

Engaging terminally ill patients in end-of-life talk: How experienced medicine doctors navigate the dilemma of promoting discussions about dying

PLOS ONE| Online – 31 May 2016 – Doctors [i.e., study participants] most commonly promoted end-of-life (EoL) talk through open elaboration solicitations; these created opportunities for patients to introduce – then later further articulate – EoL considerations in such a way that doctors did not overtly ask about EoL matters. Importantly, the wording of elaboration solicitations avoided assuming that patients had EoL concerns. If a patient responded to open elaboration solicitations without introducing EoL considerations, doctors sometimes pursued EoL talk by switching to a less participatory and more presumptive type of solicitation, which suggested the patient might have EoL concerns. These more overt solicitations were used only later in consultations, which indicates that doctors give precedence to patients volunteering EoL considerations, and offer them opportunities to take the lead in initiating EoL talk. There is evidence that doctors treat elaboration of patients’ talk as a resource for engaging them in EoL conversations. However, there are limitations associated with labeling that talk as “cues” as is common in EoL communication contexts. The authors examine these limitations and propose “possible EoL considerations” as a descriptively more accurate term.

Articles from Asia Pacific Region

Australia – Knowledge of the law about withholding or withdrawing life-sustaining treatment by intensivists and other specialists 

CRITICAL CARE & RESUSCITATION, 2016;18(2):115. Decisions about withholding or withdrawing lifesustaining treatment (WWLST) from adults who lack capacity are an integral part of intensive care (IC) practice. The authors compare the knowledge, attitudes and practice of intensivists in relation to the law about WWLST with six other specialties most often involved in end-of-life care. Intensivists performed better than average in legal knowledge but important knowledge gaps remain. Intensivists had a more negative attitude to the role of law in this area than other specialty groups, but reported being seen as a leading source of information about legal issues by other medical specialists and nurses. Intensivists also reported being the specialists most frequently making decisions about end-of-life treatment. Improved legal knowledge and open engagement with the law can help manage the risk of harm to patients and protect intensivists from liability.