Bedside manner 101: how to deliver very bad news


telepresence robot / Big Stock Photo 

A California family was shocked when Ernest Quintana, a 78-year-old man in intensive care, received the news that doctors could do no more for him and that he would die soon via a robot displaying a doctor talking to him on a television screen.

His granddaughter was with him and filmed the situation. Mr Quintana died two days later.

“If you’re coming to tell us normal news, that’s fine, but if you’re coming to tell us there’s no lung left and we want to put you on a morphine drip until you die, it should be done by a human being and not a machine,” his daughter Catherine Quintana said.

Michelle Gaskill-Hames, of of Kaiser Permanente Greater Southern Alameda County, apologised but said that the incident was very unusual. She said that telemedicine was quite useful and that normally a nurse or a doctor would be in the room during the remote consultation. “The evening video tele-visit was a follow-up to earlier physician visits,” she said. “It did not replace previous conversations with patient and family members and was not used in the delivery of the initial diagnosis.”  

“That’s not something you want to ask the loved one of a patient to do in that kind of situation,” Alex John London, of Carnegie Mellon University, told The Verge. “It created a real distance between the family and the clinician, which, instead of the empathy that you want out of this kind of interaction, further depersonalized it.”

He emphasised that this technology could be very useful, especially in remote settings. But this was not one of them. “This is exactly what people are afraid of. People are afraid that compassion in the health system and human-to-human relationships are going to be replaced with sanitized, mechanized, factory-medicine — where information is delivered without compassion, where people are left to their own devices to deal with the human element of birth, death, sickness, disease.   

Michael Cook is editor of BioEdge

  




MORE ON THESE TOPICS | bedside matter, end-of-life care

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