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Posted: July 22, 2005

Spiritual Caregiving

Speaking the Truth Matters. What We Say Matters. Trust Matters. And: Distrust Is as Dangerous as Smoking

(Editor's Note: Here is a small collection of vignettes that should provoke some thought on your part. Enjoy what we've collected.)

_____

If This Were Your Last Choice, What Would You Say? 

If you could you choose the circumstances of your death, would you choose to die more comfortably or to live longer?

 

Cindy L. Bryce, Ph.D. , and her colleagues at the University of Pittsburgh put this question to 104 people, giving them various scenarios involving an 80-year-old patient dying in an intensive care unit. Three-fourths of those interviewed were willing to trade a longer life -- seven months longer, on average -- for better end-of-life care, including improved pain control, more comfortable surroundings, and greater family support.

 

But the desire to trade time for comfort was not universal: Those who were older, nonwhite, or parents traded significantly less life for a comfortable death, while those who felt that the ICU was not a caring environment traded more time. Because of these individual differences, the researchers urge caregivers and health professionals to respect individual preferences in end-of-life care.

 

What’s Better Than Malpractice Insurance? An Authentic Apology

 

If it scares you to think of going under a surgeon’s knife or pushing through labor, consider how your doctor feels. Every human makes mistakes. For a doctor, even one paying $200,000 annually for insurance, a mistake that leads to a malpractice suit is, in the words of one website about the subject, “a stressful, life-changing event.”

 

What makes malpractice suits so wrenching and perhaps so expensive is that doctors are typically advised to keep their mouths shut when they make a mistake for fear of providing damning evidence. “Defend and deny” has been the standard legal advice to doctors. So the patient’s righteous anger builds against a wall of denial. Meanwhile, the caring doctor has to deal in silence with both guilt and fear. When the two face each other in a courtroom, catalyzed by lawyers, it should be no surprise that jury awards often become exorbitant or that many fine doctors choose to leave the profession.

 

But recently, a few simple words from doctors have become a safety valve. In one recent case reported in The Wall Street Journal, an anesthesiologist took the bold step of writing to his injured patient to say he was “deeply saddened” by her suffering. Later, over coffee, the doctor apologized for the misplaced injection that almost killed her. She accepted the apology and decided not to sue.

 

As the Journal reported, Oregon and Colorado have passed laws making it illegal to use doctors’ apologies against them in court, but even in states without such protection, insurance companies and medical schools such as Vanderbilt are now teaching doctors to own up to their mistakes.

 

The little evidence that exists suggests that when hospitals admit errors, it does not increase their costs. In fact, Annals of Internal Medicine recently reported on a study that found injured patients 50% more likely to seek legal advice when an error was not disclosed and there was no apology than when there was a disclosure and apology.

 

Distrust Is as Dangerous as Smoking

 

That’s the surprising finding of a study presented at the last annual meeting of the American Psychosomatic Society. Researchers from the Harvard Center for Society and Health interviewed 12,643 people in . After correlating attitudes with mortality rates, they discovered that agreement with the statement: “People are generally dishonest and selfish and they want to take advantage of others” was a better predictor of early death for men than smoking.

 

Jealousy -- ”If I hear about the success of a friend of mine, I am frustrated” -- was also linked with early death in men, though not in women. While religious involvement seemed to protect women from early death, it made no difference for men. What did? Neighborhood cohesion.


This article originally appeared in Spirituality & Health magazine, www.SpiritualityHealth.com. For subscriptions call 1-800-876-8202 or see www.SpiritualityHealth.com/subs. Editor Stephen Kiesling and his staff contribute weekly columns, features and articles published every Friday as "Spiritual Caregiving" at www.caregivershome.com. Contact staff directly via email at ASKspirituality@spiritualityhealth.com.

© 2005 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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