Yet, ironically, the practitioner must actually train in a very orderly fashion to be natural, spontaneous and empathetic in order to provide the most optimal dying experience for each individual. Lutzenberger Many practitioners have had the experience of walking into a patient s room and knowing intuitively that the person on the flat last bed is dying. I quickly called her primary care oncologist who stated that although he had not seen her in a month, he was planning further palliative chemotherapy. As I explained the dire nature of her condition, it became clear that he was not willing to stop treatment because he was uncomfortable telling her that she was terminal. In many instances, the patient and the family have not been fully apprised of the terminal nature of the illness.
Physicians are generally reluctant to tell a patient that all possibilities have been exhausted.
This seems to signify to some practitioners that they have failed to provide a safe haven to patients who have entrusted their lives to them. The physician must in that instant, either consciously or subconsciously, face his or her own aversions to death and their patients personal fears of the unknown. Communication is the cornerstone of palliative care medicine. It is important to contact the patient s primary physician to determine the extent to which the practitioner has acknowledged and communicated to the patient that he or she is terminally ill. Further, it is important to understand as many of the sometimes conflicting recommendations that the family has received.