Omission, Negligence, And Communicating With Terminally Ill Patients

Posted on: 5 May 2016

If you are a young doctor who has recently started working with cancer patients, then you may not know how to speak with terminallly ill individuals just yet. Even if you think you are an expert when it comes to communication, research suggests that doctors overestimate their ability to speak with patients clearly and effectively. In most cases, poor communication will cause a breakdown in the doctor and patient relationship. However, when a cancer patient is terminal, your lack of communication skills may be seen as negligence on your part. To understand this and to avoid an issue, keep reading.

Medical Negligence And Omission

Many doctors will try to provide their patients with some hope of getting better, even when a terminal diagnosis is given. Providing hope is a way of giving compassionate care. Also, hope can give patients the strength to deal with difficult cancer treatments. However, in your quest to be empathetic, you may lead your patient to believe that their condition may not be as grave as it truly is. If this causes the patient injury, then you may be sued for medical negligence. Medical negligence is described as an action that occurs outside of the duty of care that is expected of a doctor. This means that you fail to provide care to the patient or you decide to offer treatment that is not consistent with care that other physicians would provide. If these actions worsen the medical condition, cause the need for added treatments, or create unnecessary pain, then you may be sued for negligence. 

For example, you may be negligent if you inform a patient that they have stage one pancreatic cancer and that treatments are promising. While new treatments may be promising when it comes to pancreatic cancer, you likely know that 97% of patients will die within five years of a diagnosis. If you fail to mention this to patients, this may be seen as an omission. If your patient decides to put off treatment, then this may increase cancer pain and lead to the need for more aggressive treatments. This may be seen as medical negligence. 

While omission may not be your goal, the patient is likely to become confused when important information is not communicated. If pain and other medical issues are a foreseeable consequence of your actions, then the patient may have the basis for a lawsuit. In the worst case scenario, a wrongful death suit may be filed against you.

Avoiding Negligence Issues

If you are not experienced with informing patients about their terminal cancer conditions, then you should know that most patients actually prefer honest and accurate information. Research also suggests that this information should be communicated with empathy and understanding in mind. This will mean retaining a positive attitude. Make sure to speak in a slow and soft voice and allow patients to acknowledge the information you are providing to them. 

When you give details about the diagnosis, make sure to provide patients with statistics to communicate the gravity of the situation. For example, if your patient has stage one pancreatic cancer, then inform them that they have between a 12% and 14% chance of living for the next five years. Explain that survival rates are much lower without treatment though, and outline the types of treatment options that are available. Also, suggest a timeframe as to when the treatments should start. If your patient wants a second opinion, then you should also supply the names of available oncologists in the area.

Make sure to answer all patient questions. If possible, provide patients with literature as well. While you may understand medical information as a professional, your patients may not. Websites like The Mayo Clinic have a variety of resources that include informational articles to help the average person understand medical information. Consider printing out information offered by the Mayo Clinic or direct patients to their website or another website that provides easily accessible details. 

If you do end up facing a medical malpractice lawsuit, contact an experienced medical malpractice attorney or visit websites like for more information.