Researchers at two teaching hospitals in the United States investigated the emotional reactions of 188 doctors who cared for 68 patients at the time of their death.

Most doctors (74%) thought that taking care of the patient was a satisfying experience. Many reported moderate emotional impact from a patient's death, though 31% rated the death as having strong emotional impact.

Women and those doctors who had cared for the patient for a longer time experienced stronger emotional reactions. Level of training was not related to emotional reactions, but interns (equivalent to UK junior house officers) reported needing more emotional support than attending physicians (equivalent to UK consultants).

Doctors reported "feeling upset when thinking about the patient" and feeling "numb" after the death. They also reported "getting emotional support from others" and "trying to see the death in a different light to make it seem more positive" as coping strategies.

Although most junior doctors discussed the patient's death with an attending physician, less than a quarter found senior teaching staff to be the most helpful source of support.

This research provides new insights into the effect of patients' deaths on doctors and raises some questions about current medical training in the United States, say the authors. Medical teams may benefit from debriefing within the department to give junior doctors an opportunity to share emotional responses and reflect on the patient's death.

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Contact: Emma Dickinson
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BMJ-British Medical Journal
24-Jul-2003