PubMed · 8649081
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1996-05-22. [Euthanasia--an outdated idea?].. https://pubmed.ncbi.nlm.nih.gov/8649081/
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The death of a pediatric patient in the emergency department generates an intense emotional response in the physician and staff. A majority of emergency physicians describe this as the most stressful event in emergency medicine. Few emergency physicians are instructed in the complexities of dealing with the death of a child. The authors have developed a teaching module that introduces aspects of pediatric death-telling through the eyes of parents who have personally experienced the death of a child.
Although patient-physician relationships have been expressed with diverse concepts and models, we have formulated a clinimetric classification derived from several years of observation and discussions at weekly house-staff conferences devoted to "difficult" patients. The observed phenomena are classified into the following components: (1) background factors intrinsic to patient and physician before they meet, (2) individual anticipations and hopes for what may happen, (3) extrinsic features of the setting, (4) individual reactions during the encounter, and (5) the consequences thereafter. These interacting components are usually too complex for characterizations based on single models for the relationship or single titles (such as "hateful" or "noncompliant") for the patient. The components can serve as a "review of systems" for identifying manifestations, sources, and solutions to such common problems as discordant hopes, the physician's unawareness of the patient's pertinent extramedical status, psychiatric and mental-status challenges, and cogent factors in chronic illness.