The Journal of the American Medical Association is concerned how physicians communicate with seriously ill patients and their families.

There was an interesting article in the Journal of the American Medical Association concerning how physicians communicate with seriously ill patients and their families.


Criticized was a phrase that is frequently said to patients who have a disease in which there is no available cure, especially after the usual treatments were tried but could not stem the disease. The phrase is, "There is nothing more to do."


The author of the article points out a number of problems with this statement.


First, most of the time there are other things that can be done to help the patient. Doctors should add to this phrase that although there is nothing more they can do to cure the patient's illness, there are a variety of things that can be done to make their lives more comfortable.


It should also be stressed that the medical staff will be there to provide them psychological support and any other support they may need.


When hearing "there is nothing more to do," the patient may feel abandoned and that the doctor may consider that his or her responsibility and availability has ended.


This statement may also cause a rift between the patient and doctor, especially if the patient believes that more can be done and the doctor doesn't want to consider other alternatives.


Another term that was criticized was, "Would you like us to do everything possible?" Usually, the immediate answer is "yes," but the doctor and patient may have different interpretations of the term, "everything possible."


It was recommended that instead, the doctor should ask, "How were you hoping we could help?" This allows the patient to ask specifically what medical help he or she believes is needed at this difficult time.


The researcher concluded that physicians should use phrases that "truthfully communicate the care that doctors are able and ready to provide, and promote a clear understanding of what can be done. Doing this will elicit the patient's concerns, concerns that can then be further discussed. Such an approach will emphasize the enduring nature of the patient-physician relationship."


This is another example of the medical profession becoming more sensitive to patients' emotional needs.


Massachusetts-based Dr. Murray Feingold is the physician in chief of the National Birth Defects Center, medical editor of WBZ-TV and WBZ radio, and president of the Genesis Fund. The Genesis Fund is a nonprofit organization that funds the care of children born with birth defects, mental retardation and genetic diseases.