That's true, but this is not really a change of discipline for me. All treating clinicians must be able to communicate relevant info to pts already. For consent, if nothing else. If discussing death is the problem, then maybe the insurance industry can help - they do it every day
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Its hard to get why clinicians find this convo so hard. I don’t really. I’ve had (too) many people screaming murder at me after a missed/poor DNR convo. At that point, none of the reasons cut any ice with bereaved relatives; they just sound like excuses at that point.
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As you've said elsewhere - it's a legal requirement. That ought to be reason enough to ensure it happens, badly or otherwise you'd think. But the discussion still appears to be going on this much later, despite the court ruling. I'm genuinely surprised.
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I have been mostly told that it’s because of the fear of litigation because of the legal requirement.
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What is the nature of that fear Kate? Have people given specifics or is it just more general worries about being taken to court?
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Usually it’s losing their job.
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But for what: not having the converdation; having it or having it badly? Or for deciding not to offer CPR?
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The impression I get is the ‘doing it and getting it wrong’ scenario causing complaint. Weird isn’t it? The legal requirement is to discuss,it’s the non discussion that may end up in court. Poor discussion is (should be) a learning issue.
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Thanks Kate. Looked at rest of this discussion with interest. I still come back to: education for clinicians and public; starting the conversation earlier. For where we are now liked the practical and sensitive approach by
@elinlowri , as usual - 1 more reply
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