Learning empathy: medical school and the care of the dying patient

Medical education has traditionally been focused on the understanding of pathophysiology and treatment of disease. While there is an increasing level of attention focused on the doctor- patient relationship and the social aspects of medicine, there remains a relative lack of educational efforts regarding the care of individuals who are dying. This paper addresses the cultural context of medical school with respect to end-of-life care and proposes the role of physicians in caring for dying patients. In addition we report initial efforts at the University of Vermont College of Medicine to construct a preclinical course for medical students about end-of-life issues. As part of these efforts we sought to assess the attitudes of entering medical students towards end-of-life care. Review of the data suggests that the majority (66-98%, depending on measure used) of new medical students possess sophisticated attitudes regarding the care of dying individuals. Our conclusion is that medical education should seek to nurture these sophisticated attitudes and supply the basic tools of palliative care in order to improve the quality of experience for individuals who are dying.