Compassion Corner: Clinical Trial Participants Give Doctors Lower Scores Based on Delivery of Unfavorable Diagnoses

Compassion [kuhmpash-uhn] noun
A feeling of deep sympathy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate the suffering.

Compassion Corner is a weekly series from Patient Worthy that will focus on the subject of compassion in the healthcare and rare disease space. In this series, we explore the role of compassion in this field and what it means for caregivers, patients, and others.

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In view of the efforts by the clinical research industry to engineer a major facelift, an online article previously published at JAMA Network remains relevant today.

Objective

The trial consisted of one hundred eligible English-speaking adult patients attending the MD Anderson Supportive Care Clinic. The patients had all received a previous diagnosis of advanced cancer.

One of the trial objectives is to determine if the reason some physicians are reluctant to deliver ‘bad news’ is their fear of being deemed less compassionate.

The Original Investigation

Patients were to watch two 4-minute videos in which physicians (actors) conveyed an optimistic diagnosis in one video and a less optimistic diagnosis in the second video.

One of the videos showed the physician telling the patient that there were no further options available. In the second video, the physician spoke vaguely about the possibility of future treatment.

After viewing both videos, the patients were to complete the Physician Compassion Questionnaire in which they rated the physicians on a scale of 0 to 50 with 50 being the lowest rating.

The study participants and the actors in the video who portrayed patients and physicians were not informed of the reason for the study. Nor were the trial investigators privy to the theme of the videos.

In the videos, both physicians made the same number of compassionate statements even using identical postures. The patients in the video were portrayed as having received chemotherapy, were not performing well, and were not candidates for further therapy.

Survey Results

Results of the surveys indicate that by a wide margin, patients viewed physicians who gave the more optimistic message as more compassionate.

Many physicians are reluctant to give less optimistic diagnoses to patients in fear of destroying hope, causing emotional distress, appearing less compassionate, being blamed, or even having to cope with their own emotions.

Compassion can be defined as the awareness of a person’s suffering with the sincere intention of alleviating it. Compassion is a vital component of patient-centered healthcare and improved outcomes.

End of Life Decisions

It has been established that a large segment of patients with cancer in the advanced stages reach the end of life phase without knowing the extent of their illness.

For example, a study of 1193 patients found that 69% of advanced lung cancer patients and 81% of patients with colorectal cancer were not told that chemotherapy may not be effective against their cancer.

It has been found that many patients reach the end-of-life stage without ever discussing these issues.

Yet knowing treatment options as well as prognosis is essential to assist patients with their decision-making. But the information must be given to the patient appropriately. End-of-life discussions between patients and physicians result in improved care that is consistent with the patient’s values.

Conclusion

Physicians can be supported in their reluctance to deliver an unfavorable diagnosis through appropriate educational techniques and research. This would help the physician outwardly express their sincere feelings of compassion.

Rose Duesterwald

Rose Duesterwald

Rose became acquainted with Patient Worthy after her husband was diagnosed with Acute Myeloid Leukemia (AML) six years ago. During this period of partial remission, Rose researched investigational drugs to be prepared in the event of a relapse. Her husband died February 12, 2021 with a rare and unexplained occurrence of liver cancer possibly unrelated to AML.

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