First Do No Harm: Communication Surrounding Non-Beneficial Treatments

Area of Science:

• Medical Communication
• Palliative Care
• Bioethics

Background:

• Consensus exists that clinicians should not offer non-beneficial treatments (NBTs).
• Limited guidance is available for communicating NBTs, which can cause patient/family distress and conflict.
• Setting limits on NBTs may be perceived as abandonment by patients and families.

Purpose of the Study:

• To propose a framework for Palliative Care clinicians communicating about NBTs.
• To provide practical language and strategies for navigating these sensitive discussions.
• To enhance trust and minimize conflict in end-of-life care communication.

Main Methods:

• Development of a communication framework for Palliative Care clinicians.
• Inclusion of illustrative case studies with suggested communication language.
• Emphasis on proactive relationship building and understanding patient values.

Main Results:

• The proposed framework guides clinicians in compassionate limit-setting.
• Utilizing a
• breaking bad news
• approach is recommended over shared decision-making.
• Effective communication can build trust and avoid false choices for patients.

Conclusions:

• Improved communication strategies are crucial for discussing NBTs.
• A focus on relationship building and values-based limit-setting enhances patient care.
• This approach minimizes conflict and fears of abandonment for seriously ill patients.