Invoking death: How oncologists discuss a deadly outcome

Area of Science:

• Medical Sociology
• Conversation Analysis
• Clinical Communication

Background:

• Sociological research indicates patient and physician reluctance to discuss death during end-of-life care.
• Existing analyses often limit the scope of death discussions to terminal prognoses.

Purpose of the Study:

• To investigate how physicians discuss death in oncology consultations beyond the end-of-life context.
• To analyze the function and frequency of death invocations in medical interactions.

Main Methods:

• Utilized conversation analysis (CA) to examine a corpus of 90 video-recorded oncology visits.
• Expanded analytical parameters to include mentions of death outside of strictly end-of-life scenarios.

Main Results:

• Physicians frequently invoke the possibility of patient death during treatment recommendation discussions.
• Death invocations serve as a persuasive tactic to overcome patient resistance to recommended treatments.
• Mentions of death were also observed when resistance was anticipated but not explicitly expressed.

Conclusions:

• Physicians utilize discussions of death as a strategy to advocate for specific treatment plans.
• Invoking death leverages physician authority to influence treatment decisions and achieve desired outcomes.