As doctors, we have been taught how to communicate with patients, how to treat them and we have even been taught how to break the bad news to families. However, continued interaction with the patient’s family after the patient’s death is never taught and never addressed.
Just like death is inevitable for every human being, watching patients die is inevitable for a doctor. Doctors might forget the first patient they treated but they usually do not forget the first patient that died in their care.
There is a notion that doctors are not affected by the death of a patient, but the truth is that every life matters as much to us as it matters to others. In fact, it may matter even more, because the patient’s death could be construed as a failure of sorts in the job assigned to us – we failed the family that trusted us and we failed the person who believed that we can make them better.
It is a fact that many young doctors have suffered transient depression after the death of their patients, and it is only after years of practice that they learn how to cope with such circumstances. In the various coping mechanisms that doctors adopt, the one mechanism that remains highly debated, is attending a patient’s funeral.
Attending your patient’s funeral is not a popular practice across the world and most doctors have not even thought of this. But surprisingly, there are doctors who attend the funerals of all their patients. And these few doctors who attend the funerals of their patients find it very helpful. Funerals are a way to extend respect to the person and the life that their patient lived.
The doctor-patient relationship is a period of learning and relearning. So, when a patient dies, a proper farewell in the form of attending the funeral can not only be a great coping mechanism for the doctors, but a learning experience too. At the funeral, they get a chance to interact with the family and friends of the patient and to know more about their patient, the life he/ she lived and the struggles they had faced. This little conversation can help them understand the human being who was their patient and even resolve any emotional disputes that might have arisen during the long treatment. It is said that if you understand the struggles of a person, you are able to connect to him/ her better. Thus this experience that doctors get in attending a patient’s funeral can make them more empathetic towards other patients that they treat. Some doctors have shared that this single visit bonds them with the patient’s family in such a way that the families start respecting their opinions over other doctors. And in many little ways it improves us as doctors and our future doctor-patient interactions and skills.
On the other hand, for the doctor the added responsibility of attending the patient’s funeral can be tiring as he/she already has held the responsibility of taking care of the patient and reassuring them and the family throughout the various phases of the illness, Attending the funeral of all patients may become a professional and emotional burden for doctors. Many doctors have mentioned that their long working hours leave them with very less time for themselves and their families, so adding the responsibility of attending the funerals does not seem fair. Along with this, the funeral attendance can likely have a negative impact. The professional performance of the doctors can get affected because funerals can trigger emotions that lead to blurring of professional boundaries and objectivity of doctors. In many situations when the doctor is somehow considered responsible for the loss of the patient’s life, it may not be an intelligent decision to think about attending the patient’s funeral. In such situations the doctor may be unwelcome, leading to difficult and embarrassing situations for both the doctor and the patient’s relatives.
Of course, the pros and cons in this matter, may vary depending on the situation, the family in question and local cultures. In western cultures, it is easier to find doctors who attend their patients’ funerals but in comparison in India one hasn’t heard of any doctor who does this.
Unlike Western/Christian funerals customs which celebrate and remember the good about the person, the Hindu funeral ritual is very different. It is common to see exhibition of extreme emotions, which can be emotionally draining for the doctors.
Also in recent times, in India, there is an increasing tendency to hold the doctor responsible for the death of the patient, as evident increasing cases of violence against doctors. So, in such an environment, an act like attending the patient’s funeral might not be considered as a good intention.
The high patient load on doctors in India also makes it difficult for doctors to adopt this practice.
But the medical professionals in India need to open their eyes to this practice, which has the potential of redefining a doctor-patient relationship.
So next time a patient you are treating dies, think whether you want to attend his funeral. Consider whether it will be good for you and for the patient’s family. Lastly, before you attend think what your patient would have felt about this? Maybe he/she would have liked you to attend!