Essay Urging Doctors to Attend Patients’ Funerals Draws Support

An assertion that doctors should attend their patients’ funerals has touched off an outpouring of support--and some dissent--in the New England Journal of Medicine, it was reported Wednesday.

Several doctors agreed that their responsibilities to patients and the families left behind do not end at the moment of death. But one physician’s wife lamented that adding funerals to doctors’ duties would further cut into the time they spend with their own families.

The letters in today’s issue of the journal were a response to an essay by Dr. Patrick Irvine of the St. Paul-Ramsey Medical Center in St. Paul, Minn., that appeared in the magazine last June.

‘Look a Bit Distant’

“I am reluctant, almost embarrassed, to bring this up with colleagues,” he wrote. “When I do, they look a bit distant and become quiet. They haven’t thought about it much, or so they say. Few with whom I have talked have ever attended patients’ funerals.”

Going to patients’ wakes and funerals gives families a chance to talk about their own experiences during the death, he said. It demonstrates that the doctor valued the person who died.

And it helps the doctor, too. “My feelings need resolution just as the family’s feelings do, and society’s rituals help me with that as well,” he wrote.

Irvine cited a survey, published last year, showing that fewer than 10% of doctors send cards or flowers or attend their patients’ funerals.

‘Acknowledge Death’

In response, Dr. Julia E. Connelly of the University of Virginia School of Medicine wrote: “Attending the funeral, viewing the body or writing a letter forces the physician to acknowledge death. It forces him or her to face the sadness and pain, the guilt and the frustration of losing a patient.”

Dr. L. L. deVeber of the University of Western Ontario wrote that a visit to a funeral home can be a rewarding experience.

“Considering the many hours of time we may spend attending the terminal patient,” the doctor wrote, “a short visit to the funeral home seems a small investment for the physician and the family.”

And Dr. Burton A. Lerner of Columbia University said Irvine “reminds us that the work of the physician as a psychologist in human behavior is not necessarily finished when the patient dies.”

Conferences Arranged

However, Dr. William L. Hedrick of St. Mary’s Hospital in Minneapolis responded that a wake or funeral is not the best time to talk with a deceased patient’s family. Instead, he arranges a conference with the family a month or so after the death to review the illness and answer questions.

Susan F. Schulman, wife of a Seattle doctor, wrote that she hopes that physicians do not follow Irvine’s example.

“I feel that my children and I need father and husband far too much to have our family time shortchanged by one more professional activity, however noble that activity may be,” she wrote.