October 9, 2019

Why doctors do (and don't) attend their patients' funerals

Daily Briefing
    Editor's note: This popular story from the Daily Briefing's archives was republished on July 22, 2021.

    While most doctors participate in their own bereavement practices following the death of a patient, it's uncommon for them to attend a patient's funeral, according to a research review published recently in the journal Medicine.

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    Coping with patient deaths

    When a patient dies, hospitals often offer bereavement services to the patient's family, such as memorial services and bereavement coordinators, according to Reuters. The clinicians who treated the patient also may participate in their own bereavement practices, such as calling the family to offer their condolences.

    But few physicians talk about the bereavement process, Reuters reports. Greg Crawford, an associate professor of palliative medicine at the University of Adelaide in Australia, said that a patient's death can be "a very emotional and isolating experience for physicians," which can make clinicians less likely to attend a patient's funeral to cope with the patient's death.

    Research review details

    To determine how often clinicians attend patients' funerals and why, a team of researchers, led by Laurence Weinberg from the University of Melbourne, analyzed 46 articles published between 1990 and 2017 that sought to determine what factors were likely to influence whether a doctor  attended a patient's funeral. The research review included 18 cross-sectional studies conducted in the United States, Australia, Canada, Ireland, and Israel. 

    The analysis revealed funeral attendance for clinicians varied based on several factors, including medical specialty. For instance, up to 67% of palliative care practitioners and psychiatrists attended patients' funerals compared with 22% of hospital intensivists.

    Attendance also varied by age and gender. One study found that female pediatric critical care specialists were more likely than other clinicians to participate in bereavement practices, while another study found younger doctors were less likely to attend funerals than older doctors. 

    Doctors who did attend said they went to support the patient's family, demonstrate respect, extend the professional relationship, and resolve guilt. Doctors who did not attend funerals cited personal discomfort, discouragement from colleagues, and blurred professional boundaries.

    Should more doctors attend their patients' funerals?

    Sofia Zambrano of the University Center for Palliative Care in Switzerland said, "[T]here is a lot of silence" among doctors about bereavement practices. "Many see them as signs of weakness" or as something that limits "the objectivity of physicians," she said. As a result, bereavement is "seldom openly addressed" among doctors, "leav[ing] physicians wondering whether it is okay to do it or not to do it," Zambrano said.

    Psychiatrist Shailesh Jain of the Texas Tech University Health Sciences Center in Midland who wasn't involved in the study said doctors should try to attend the patient's funeral "if possible."

    "This gesture often is welcomed by the family and facilitates the grieving process," Jain said.

    In order for physicians to feel encouraged to participate in bereavement practices, medical professionals should have open discussions about patient deaths and what comes after so clinicians can create and adopt their own bereavement policies, Zambrano said. She added that future research should aim to better understand attendance across different specialties and specific instances in which doctors should be required to attend the funeral as part of practice (Crist, Reuters, 9/26; University of Adelaide release, 9/22/16).

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