Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Should doctors conduct patients' funerals?
- Trevor Stammers (23 June 2007)
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Should doctors go to patients' funerals? Certainly not HIV Physicians!
- Kathir Yoganathan (26 June 2007)
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Select your funerals carefully
- Andrew N Bamji (2 July 2007)
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Bereavement phone calls and funerals
- Mark A Rickenbach (4 July 2007)
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Personal reflections on doctors attending funerals
- Ros Thorburn, Martin Roland (Professor of General Practice) (10 July 2007)
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Should doctors go to patients' funerals
- David P B Pound (17 July 2007)
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Author's reply: Should doctors go to patients' funerals
- Karen Falloon, Bruce Arroll (27 July 2007)
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Trevor Stammers, Lecturer in Healthcare Ethics St Mary's Uinversity Colllege, Twickenham, TW1
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In 23 years of general practice, I have been to many patients' funerals and would agree with Bruce Arroll and Karen Falloon on the therapeutic advantages of this for the bereaved families. At one funeral of an elderly spinster I had looked after for 20 years, I was the only mourner apart from her nephew and the the funeral director and his staff. My most memorable patient's funeral however was one he had asked me to conduct. I knew him well and paying this last tribute to him, though not easy, was a very special honour. Anyone may conduct a funeral service at a crematorium. The staff were very helpful in making the preparations and intructing me in what to do. If doctors are asked by their patients to conduct or participate in their funerals I would certainly recommend them to do so. Competing interests: None declared |
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Kathir Yoganathan, Consultant Physicisn Swansea NHS Trust,Singleton Hospital,Swansea,SA2 8QA
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Dear Editor I read Arroll et al article with great interest1. Like general practitioners I manage patients with chronic illness, mainly HIV/AIDS for the long term. Even though doctors are professional they do become friendly not only with patients but also with their families, especially in specialities dealing with chronic illness. I have been frequently invited to attend funerals by patients’ families. One day I decided to attend the funeral of a man who died of AIDS. Though his wife knew his cause of death his close family and friends were not aware. Furthermore I met a few other patients with HIV/AIDS who were under my care in that funeral. Some people could have guessed his cause death because of my presence, as I was an only HIV/AIDS Physician in that small community. That would have been a breach of confidentiality. We should respect patient’s confidentiality even beyond the grave. Since then I have stopped attending funerals and I believe physicians who look after ‘confidential illnesses’ should exercise caution before attending patients’ funerals. Reference: 1) Arroll B, Falloon K. Should doctors go to patients’ funerals? BMJ 2007; 334:1322. Competing interests: None declared |
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Andrew N Bamji, Consultant (Rheumatology/Rehabilitation Queen Mary's Hospital, Sidcup DA14 6LT UK
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In the rehabilitation field one sees patients over many years and so get to know them well - as well as their families. However there are funerals I will attend out of respect and those I will not - these latter usually because there have been traumatic issues around the time of death, so that my presence might serve only to allow questions, or recriminations, that would be out of place. Patients' funerals can be very humbling. I remember one, of a police officer who had many years before sustained a high spinal cord injury while on duty, whom I had got to know very well through the numerous alarms and excursions attendant on someone with only half a diaphragm to breathe with. Or so I thought. The service was packed with police officers whose tributes made me realise how little I knew him and how arrogant I had been to presume that I did. Competing interests: None declared |
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Mark A Rickenbach, GP Park Surgery, Hursley Road Chandlers Ford SO53 2ZH
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Arroll and Falloon, outline the benefits of attending funerals of patients and I agree with them in all areas except the issue of a “small investment of time”. A busy general practitioner often does not have time in the day to attend those funerals they would like to. However, I have made it a point to ensure phone contact with all relatives of patients who have died under my care and have subsequently been able to support relatives at bereavement visits or surgery appointments. This phone call to a close relative provides an opportunity to express sympathy, check on family support, assess the severity of their grief and determine if a follow up visit is required. It also provides an important route of self audit and can resolve misunderstanding which might otherwise erupt into medico legal problems. More often than not relatives will be very grateful and it may give an opportunity for valued positive feedback and encouragement. Finally it helps you to come to terms with one’s own, albeit much smaller, loss and associated reminder of mortality. Yes, do attend funerals if you are able, but I would suggest you always try to find time to phone a relative of your patient if they have recently died. Competing interests: None declared |
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Ros Thorburn, Consultant community paediatrician Child Development Centre, Guardian House, Guardian Street, Warrington, WA5 1TP, Martin Roland (Professor of General Practice)
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When our son died of cancer last year at the age of 25, a number of his doctors and nurses came to his funeral. We were not able to talk to them at the time but we knew that they had been there as they filled in cards which the funeral director provides. We have had contact with one or two of them since, and the shared experience was of tremendous importance. It meant a lot to us that they had taken time out of their busy schedule to come. For us it was an important mark of respect for our son. It showed that they cared and was part of a long healing process. As a community paediatrician (RT) I have tried wherever possible to attend the funerals of disabled children under my care. I have usually grown to know the families well. The untimely death of a child or young adult is devastating and families have always seemed to appreciate my presence. We cannot always cure but we can always care. My personal experience has reinforced this feeling a hundredfold. Ros Thorburn and Martin Roland Competing interests: None declared |
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David P B Pound, Retired GP Daventry NN11 3YT
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When I was in practice I tried to get to funerals whenever I could, for the reasons cited by other correspondents. I found, again like others, that my presence was usually welcomed. Having now retired, the information I get about the deaths of former patients may be rather slow, and by the time I read of a death in the local weekly paper the funeral date may have passed. When I can attend however, I do, and my presence now seems to be welcomed if anything rather more than when I was still working. It certainly quite often occasions surprise. When I cannot attend I try to write a note or short card to the family, and I have had some very touching responses to such messages. It seems to me that we may underestimate the comfort which the unexpected attendance or notice of a current or former medical attendant can bring to a bereaved family. Competing interests: None declared |
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Karen Falloon, Academic Registrar Department of General Practice and Primary Health Care, University of Auckland, New Zealand, Bruce Arroll
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Our recent editorial was entitled: Should doctors go to patients’ funerals? We were posing the question to ourselves, but also to doctors everywhere. It was heartening to receive many positive and supportive responses to both the published editorial and to the subsequent interviews performed. We were privileged to hear personal stories from patients’ relatives as well as learning about a range of practices doctors were undertaking to convey a gesture of respect and support following the death of a patient. These responses were instructive to us as authors and have left us with a more complete answer to our question. Should doctors go to patients’ funerals? If possible and appropriate, yes. Should doctors have some method whereby they convey a gesture of acknowledgment, compassion and support? Absolutely. Dealing with the death of a patient is not something that appears to be a part of the medical school curriculum, however it is a situation that we as doctors universally face. In terms of dealing with the external situation (personal coping with grief is a more complex issue) perhaps the only preparation that is necessary is an appreciation of how important our role can be following the death of a patient and some forethought as to what form that role may take. Attending the funeral is only one such option. The personal responses we received from the relatives of patients where the doctor was able to attend speak of heartfelt appreciation that is remembered even as the years pass. Few negative comments were received regarding this proposition although the restrictions that time constraints impose were highlighted. Many other options are available to both the doctor and the practice team as a whole to considerately respond to the passing of a patient. For those who aren’t able to attend a patient funeral or feel it is
not appropriate the following may be acceptable options:
Different gestures will be more appropriate to different work environments. Collaborative efforts or meetings have the added benefit of supporting team members who may feel upset about the patient death. Dying is an inevitable conclusion to living yet so often the impact (and even sometimes the event) of death is ignored. Caring for our patients’ families, our colleagues and ourselves in the wake of a patient death is expressing our own humanity. It may just make us better doctors and people. Competing interests: BA is on the advisory board for the Pharmac educational seminars (Pharmac is the government funded pharmaceutical purchasing agency in New Zealand) and is on the primary care committee of the Future Forum, an educational foundation funded by Astra Zeneca (UK). |
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