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The Imperatives of Family- and Surgeon-Centered Care

Dan Taylor, PhD; Moustafa A. Hassan, MD; Arnold Luterman, MDCM, FRCS(C); Charles B. Rodning, MD, PhD

Arch Surg. 2008;143(1):87-92.

Conveying to family members that their loved one has unexpectedly died during an operation is perhaps the most stressful task a surgeon must perform. The loss of a patient's life precipitates enormous personal and professional anxiety and stress on a surgeon: profound grief, damage to self-esteem, loss of self-confidence and reputation, and the specter of litigation. Most surgeons feel unskilled in such a setting, yet how they communicate—what they say and how they say it—is extremely important for everyone involved. Two distinct, but interactive, phases of response are relevant when communicating with a family before and after an unexpected death of their loved one: a proactive phase ("CARE") intended to establish a positive therapeutic relationship, and a reactive phase ("SHARE") intended to respond to the crisis in a compassionate and respectful manner and to ensure self-care for the physician.

Author Affiliations: Departments of Internal Medicine (Dr Taylor) and Surgery (Drs Hassan, Luterman, and Rodning), College of Medicine and Medical Center, University of South Alabama, and Christian Medical Ministry of South Alabama (Dr Taylor), Mobile.