Multi-staged death.

Been mulling the wise post over at St. Emlyns about little white lies.  http://stemlynsblog.org/2012/09/little-white-lies-in-the-resus-room/

Then was having a discussion with a local vet about breaking bad news. He told me about his favourite method which he calls the multi-staged death.

So he will often get a cat/dog that has been hit by a car, usually arrive with a distraught owner who asks for him to do everything possible to save them. Firstly he explains its touch and go and that they should say their goodbyes and go home. Then he does what he can for the critter.

If it goes badly and they don’t survive or if the injuries are simply unsurvivable he initiates the multi stage death protocol. Sometimes  he will do this  after the animal has passed away.

(Stage one) First his nurse calls to tell them it’s not looking good. This gives them an early warning about the likely outcome.

(Stage two) A short while later he calls to tell them he’s going to take their pet to theatre and he will “Do what he can” further preparation of owner.

(Stage Three) Then finally he calls back and breaks the bad news that despite all the best efforts the injuries were not survivable. Gives closure, they feel all that could have been done has.

He swears by it as being a great way to prepare the owners for the likely outcome and is much better than the “Will call you when its done, either way” approach of his practice partner.

Now im not advocating this approach for patients but found it an interesting approach. Thoughts?

 

Comments

  1. Michelle Johnston says:

    Very interesting! And I particularly love the nurse employed to ring with the stage one news.
    I believe that the term ‘we’re doing all we can’ is a wonderful umbrella, as it has many elements to its interpretation, and when it is said in good faith, has much power and meaning. That the interpretation by care-givers, and relatives may be somewhat at variance, is not so important, if it is a term used ethically and appropriately.
    Don’t agree with the whole blatant lie about timing of death here (wouldn’t sit comfortably in the human world), but hell, if anyone could get away with it, it would be the two upstanding people in your pictures here :-)
    Like everything in medicine, there is no one phrase fits all, and needs to be individualised to each situation, but without question, honesty and accountability is paramount in the world of medicine. Not sure how the pet owners would feel if they accessed the surgical records under FOI (for reasons why not clear to me at this moment) to find that a purposeful lie was told, even for the ‘right reasons’. But this is obviously a vet who cares very much for his human ‘patients’ as well as his canine/feline/other, so hale to him.

    • Hi Michelle, sorry to take so long to reply. i managed to break by site…oops.
      I understand the feeling of unease about the timing of the critters death.
      but find it interesting your thoughts goto the legal repercussions of an action.
      Maybe I should check with some other vets and see if its consistent with a body of his peers ;)
      Finally we all know taking your glasses off is a sure sign the conversation is getting serious.

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