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CONVEYING SENSITIVE INFORMATION TO THE     PATIENT AND THE FAMILY<br />KavyaKurkal<br />Seth GS Medical College<br />
        WHAT NOT TO DO<br />
       6 STEP PROTOCOL<br />Getting started<br />What does the patient know?<br />How much does the patient want to know?<...
DEATH<br />
WHY?<br />For the benefit of the patient’s family and friends<br />
For the benefit of the doctor<br />
      For the benefit of the medical student<br />
HOW?<br />Here are a few basic steps to follow:<br />PREPARATION<br /><ul><li>Should know the history of the case
Should be able to explain in simple terms
Should be armed with answers to all possible questions
Should remain calm and composed
Should not appear impersonal or disinterested</li></li></ul><li>METHODS:There are two methods available:<br />Telephonical...
CONDITION UPDATES:<br /><ul><li>Many families express anger and feelings of helplessness
Keep family updated during resuscitation
Balance the needs of the patient and family</li></li></ul><li>RESPONSIBILTY OF COMMUNICATING DEATH<br />I<br />t is the re...
MANNER OF CONVEYANCE<br /><ul><li>Medical facts are less important than compassion
Do not go into the technical details
Give them time and space
It is their right to ask as many questions as they want
It is left to the discretion of the doctor as to how much information to divulge and to maintain a balance
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Communicating sensitive information to the patient

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Communicating sensitive information to the patient by Kavya Kurkal

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Communicating sensitive information to the patient

  1. 1. CONVEYING SENSITIVE INFORMATION TO THE PATIENT AND THE FAMILY<br />KavyaKurkal<br />Seth GS Medical College<br />
  2. 2. WHAT NOT TO DO<br />
  3. 3. 6 STEP PROTOCOL<br />Getting started<br />What does the patient know?<br />How much does the patient want to know?<br />Sharing the information<br />Responding to patient and family feelings<br />Planning and follow up<br />Taken from ‘ How to Break Bad News: A Guide for Health Care Professionals’ by Robert Buckman<br />
  4. 4. DEATH<br />
  5. 5.
  6. 6. WHY?<br />For the benefit of the patient’s family and friends<br />
  7. 7. For the benefit of the doctor<br />
  8. 8. For the benefit of the medical student<br />
  9. 9. HOW?<br />Here are a few basic steps to follow:<br />PREPARATION<br /><ul><li>Should know the history of the case
  10. 10. Should be able to explain in simple terms
  11. 11. Should be armed with answers to all possible questions
  12. 12. Should remain calm and composed
  13. 13. Should not appear impersonal or disinterested</li></li></ul><li>METHODS:There are two methods available:<br />Telephonically<br />In Person<br />
  14. 14. CONDITION UPDATES:<br /><ul><li>Many families express anger and feelings of helplessness
  15. 15. Keep family updated during resuscitation
  16. 16. Balance the needs of the patient and family</li></li></ul><li>RESPONSIBILTY OF COMMUNICATING DEATH<br />I<br />t is the responsibility of the physician who has been treating the patient and this responsibility should not be delegated to anyone else unless absolutely necessary.<br />WHEN IS THE ‘RIGHT’ TIME?<br />There is no such thing as the ‘perfect’ moment.Try to break it down gently . Do not be in a hurry or abrupt.<br />
  17. 17. MANNER OF CONVEYANCE<br /><ul><li>Medical facts are less important than compassion
  18. 18. Do not go into the technical details
  19. 19. Give them time and space
  20. 20. It is their right to ask as many questions as they want
  21. 21. It is left to the discretion of the doctor as to how much information to divulge and to maintain a balance
  22. 22. Try to inform all the family members in a group</li></li></ul><li>FAMILY REACTION<br />GUILT<br />SORROW<br />DENIAL<br />ANGER<br />ACCEPTANCE<br />DEPRESSION<br />
  23. 23. VIEWING THE BODY<br /><ul><li>Necessary evil
  24. 24. Prepare the body
  25. 25. Families of mutilated patients should be warned
  26. 26. Viewing can done individually or in a group privately
  27. 27. If patient is a child, wrap in blanket and give parents opportunity to hold child</li></li></ul><li>CONCLUDING THE PROCESS<br />Effective communication continues beyond this as there are a few issues left to be dealt with by the family. The family members should be encouraged to contact the doctor if any queries arise.<br /><ul><li>Mortuary
  28. 28. Autopsy
  29. 29. Tissue and organ donation</li></ul>Let the family know that they can stay at the hospital for as long as they want<br />
  30. 30. DEATH OF A CHILD<br />It is a particularly sensitive situation.<br /><ul><li>Give parents enough time to hold child
  31. 31. Religious preferences and ceremonies
  32. 32. Information to nursing mothers
  33. 33. Informing the child’s sibling
  34. 34. Offer to preserve momentos</li></li></ul><li>RED FLAG SIGNS<br />
  35. 35. AFTER DEATH<br /><ul><li>The practice of using the newly dead for the purpose of medical research and advancement has met with increasing controversy
  36. 36. Problems of disclosure and informed consent
  37. 37. Difficult to approach a grieving family
  38. 38. Other ethical issues arise from cultural differences in treating the body of the newly dead
  39. 39. Currently no universal guidelines or official policies regarding this practice exist.</li></li></ul><li>ROLE OF THE MEDICAL STUDENT<br /><ul><li>Importance of providing appropriate and adequate training to medical students in patient communication
  40. 40. Students should be allowed to accompany the physician while disclosing sensitive information
  41. 41. Students should be encouraged to discuss the experience with the physician
  42. 42. Student must not be made to convey information to the family directly
  43. 43. The houseman should actively participate in such conveyance as part of his training albeit under supervision initially.</li></li></ul><li>CONCLUSION<br />

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