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What’s a doctor’s duty to inform when a patient is dying?

| Sep 28, 2018 | Doctor Errors

A curious phenomenon took place at a Rhode Island nursing home. A young stray cat took up residency there and unsettled the medical staff with his unerring accuracy of predicting patient deaths within hours or days.

They learned that when Oscar the cat nestled in beside a patient, it was time to call the patient’s family members in to say their goodbyes.

The record reflects it

No one considers The New England Journal of Medicine to be lighthearted reading. In 2007, the publication contained the story about Oscar and his scarily accurate ability to predict residents’ impending deaths even when their doctors had no other indications that the end of life was near.

According to the article, Oscar went 50-0 with his predictions at the Steere House nursing home. While scientists are unsure how he could so accurately predict pending deaths, his technique including sniffing the air around the patient. It’s believed the feline may have caught a whiff of a scent associated with death on the patients.

Many doctors might wish they, too, possessed Oscar’s uncanny knack. They probably have endured the repercussions of a patient’s death when said patients (or the family members) were not properly informed it was imminent.

Doctors and the duty to inform

What, then, is the physician’s duty to inform patients of their chances of succumbing to their illnesses and conditions? Some patients want to know everything and ask their doctors to try to narrow down their expected timeframe for death as much as possible.

Others can’t cope with facing their own mortality and prefer to go out either fighting or oblivious to the reality. Doctors have the duty to adequately inform their patients of the expected prognosis they face given their physical circumstances and the usual course of the disease. They don’t have to browbeat a reluctant patient into facing their own mortality within weeks.

Possible predictor?

One British study found that doctors were all over the map in accurately predicting patient deaths. Some were close, but other prognostications either fell far short or wildly overshot the mark.

Two years ago, a Stanford grad student attempted to teach a “dying algorithm” to a hospital palliative care team. It performed well, with low false-alarm rates and high survival rates for those with low scores on the algorithm’s scale.

Until science advances further, patients must rely on their adequately provided doctor’s best time of death estimations.


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