Which Critical Communication Skills Are Essential for Interdisciplinary End-of-Life Discussions?

AMA J Ethics. 2018 Aug 1;20(8):E724-731. doi: 10.1001/amajethics.2018.724.

Abstract

Conversations about dying and end-of-life (EOL) care are the most challenging of all communication scenarios. These conversations include discussions about diagnosis and prognosis, treatment goals, and EOL wishes, goals of care, and plans for the future. Research has identified critically important skills involved in holding such conversations, and protocols have been established that can assist those discussing these important issues. Often several discussions and professionals from multiple disciplines are needed to ensure that EOL conversations are effective and comprehensive. In this article, we review what is known about the skills and strategies necessary for meaningful and effective EOL conversations and emphasize the valuable role of interdisciplinary approaches to these discussions. Advanced care planning (ACP), which refers to patient decisions about desired care should the patient lose decisional capacity, is included as a type of EOL discussion in this article.

MeSH terms

  • Adult
  • Advance Care Planning / standards*
  • Attitude to Death
  • Curriculum
  • Decision Making
  • Education, Medical / organization & administration
  • Female
  • Humans
  • Interdisciplinary Communication*
  • Male
  • Middle Aged
  • Palliative Care / psychology*
  • Palliative Care / standards*
  • Patient Care Team*
  • Qualitative Research
  • Terminal Care / psychology*
  • Terminal Care / standards*
  • United States