Coping Mechanisms of Physicians Who Routinely Work with Dying Patients

Physicians routinely care for dying patients, yet many report being uncomfortable doing so. Discomfort with death can compromise patient care through insensitive or inadequate interactions and can lead to physicians' feeling remorse, anger, guilt, and inadequacy. The purpose of this study was to explore how physicians cope with the discomfort of caring for dying patients, as well as how the coping process can affect patient care. Twenty physicians who routinely cared for dying patients were interviewed about related discomfort. Transcripts were analyzed according to the grounded theory method using Atlas/ti software. Eight coping mechanisms were identified, including medicalization, dehumanizing the patient, anger directed at the patient, use of euphemisms, use of humor, denial of the lack of skill, going numb, and talking to others. Improvement of support mechanisms would provide a forum for physicians to speak about discomfort and would encourage the development and sharing of productive coping mechanisms.