"Where are they?" The Range and Implications of Clinician Reactions to Absent Families

In "Can I Get a Witness? The Ethical Dimensions of Family Presence in Patient Suffering," Jennifer Blumenthal-Barby and colleagues ask us to scrutinize "the instinct to blame families" who are absent from the care of their seriously ill loved ones. In this commentary, I use a common framework of differential diagnosis to consider the reasons for and implications of clinician reactions to absent families. As we better understand what might be driving the absence of family members, we might also find hints at the sources of our own judgment. As with most differential diagnoses in medicine, this analysis can also help to inform how we support those families and manage our own instincts.