The document discusses two recent studies on attitudes towards death and end-of-life discussions. The Co-operative Funeral Care report found that most people only think about their own mortality when prompted by external events like a family death or medical diagnosis. They also do not discuss death with others. Similarly, a Royal College of Physicians report found doctors have difficulty discussing death with patients, even more so than patients themselves. The document argues doctors have an important role in assisting families with practical and healthy end-of-life conversations to help reduce pain for all involved.

1. Doctors – it’s over to you
Two recent pieces of research have shown us what no
funeral professional will be surprised to hear; we really
don’t want to talk about death.
Co operative Funeral Care has looked into when we
consider our own mortality and why. The report found
that most people only think about their own death
when prompted by an external cause, such as a family
bereavement, medical diagnosis or a milestone
birthday. Furthermore, even if people are thinking
about death, they aren’t talking to anyone else about it.
At the same time, the Royal College of Physicians (RCP)
has produced the Talking about dying report as part of a
campaign to improve the skills of doctors, who
increasingly have to deal with end-of-life care. Doctors
find it even harder to talk about death than their
patients it seems.
Looking more closely at Co operative Funeral Care’s
report, it is clear that a number of factors govern their
findings: the older we get, the more ready we are to
think about death; religious people seem to be more
reluctant to think about it than atheists and agnostics;
people who probably would like to talk about death –
most particularly their own – fear doing so in case it
upsets those close to them.
For doctors, there are additional cultural issues at play.
Physicians spend their careers trying to save lives and
are reluctant to admit failure. Although they may build
close relationships with patients, they are not friends or
family and, in many cases, they have only the most
basic professional relationship with the patient. There
is the difficulty of answering impossible questions in
relation to timescale and levels of suffering, along with
the hope that families will discuss the subject privately
amongst themselves. Young doctors may have very
limited direct experience of death, making it hard for
them to fully empathise with patients and families.
Over time, they can develop a standard approach to
terminal cases which never really changes.
As we know, all of this is unnecessary - death is the
prognosis for every single one of us. However painful
or difficult these conversations are, the fear of them is
almost certainly greater than the reality. Doctors have
a key role to play by assisting families to have practical,
healthy conversations about the end of their life and
the arrangements they wish to make. If we can change
the culture, we can save a lot of people a lot of pain.
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