End-of-Life (EOL) is hard, difficult, sad, gentle, blessing, beautiful etc.
EOL situations can be a bundle of so many different emotions, and possible decisions, that it can be overwhelming for the loved ones of the dying.
So often, medical wishes are not discussed beforehand, therefore making these decisions can feel like pressure and uncertainty.
When these situations arise, and the doctors come to speak with the family, so many feelings are on the surface, that the family often looks to the physicians for guidance and assurance.
A University of Pittsburg School of Medicine study was conducted to investigate "how a doctor's choice of words, or how his/her empathy and personal experience, can impact a family members' decisions to approve or not approve CPR to save a critical patients life?
This study (did not use actual patients) shows how important doctors language can influence decisions based on the different versions of the CPR explanation.
The physicians used phrases below with brief explanations:
CPR - Cardiopulmonary Resuscitation
DNR - Do Not Resuscitate
“Simple changes of words and perceptions about social norms resulted in large differences in CPR choices” and “This study suggests that the change isn’t just window dressing — it makes a real difference in the choices that people make. We expect that it also may reduce feelings of guilt for choosing against CPR by making family members feel like they are doing something positive to honor their loved one’s wishes at the end of life, rather than taking something away from them.”
The bottom line is that yes, physicians can influence medical decisions for EOL, but more importantly, it also shows the importance of having these conversations with your loved ones way before a medical crisis occurs, so that the anxiety and guilt is reduced and the focus is put back onto the needs of the dying and ensuring they are comfortable without heroics that tend to cause more harm to the dying.