‘Everything will be fine.’
No doubt you or someone you know has heard these words from a doctor, but now doctors are being warned to desist as it could lead to false hope.
A new report has identified twelve ‘never phrases’ that doctors should never use with patients with serious illnesses, such as heart failure, cancer and lung disease.
They explain that these “single words or phrases are not only of no use, but can also cause emotional damage and accentuate power differentials.”
For example, if a patient is seriously ill, a doctor should never use the words “withdraw care” because it implies that the medical team is “giving up.”
While “everything will be fine” may seem like a reassuring phrase, the researchers say it can provide false hope when it comes to a serious illness. A better phrase might be, “I’m here to support you through this process. ‘
This means that no promises are made and the outcome remains undetermined. Likewise, the study authors who say something like “we’re going to fight this together” would be “implying that sheer will can conquer disease.”
But the study comes amid growing concerns about the “wokification” of medicine, with doctors becoming too afraid to be honest with patients.
As part of an in-depth study published in Mayo Clinic Proceedings, four researchers looked at ‘never words’ and ‘what not to say to patients with serious illness’ (stock image)
The new report, published in the journal Mayo Clinic Proceedings, was conducted by four researchers: three with a medical background and one with experience as a seriously ill patient.
Drawing on their own experience in the medical field and speaking with twenty external physicians, the team identified twelve ‘never words’ and phrases that should not be used during end-of-life care.
First on their suggested list of “never words or phrases” is the blunt phrase, “there is nothing else we can do.”
Instead, they propose a gentler approach to the situation, with their suggested dialogue stating: “Therapy and, hopefully, your quality of life. to live.’
The researchers explain their rationale as follows: ‘Even without the prospect of a cure, the physician can still convey the ability to treat the patient as best as possible.’
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Then the experts say it’s a total no-no to tell friends and family that a patient “won’t get better.”
Instead, they suggest the phrase “I’m afraid that
Instead, the paper states that an alternative comment for family or friends could be: “We can shift our focus to his/her comfort rather than continuing with the current treatment, which is not working.”
The researchers were shocked to find jargon emerging among medical staff and they say that “circling the drain,” in reference to a patient’s quick determination and possible death, should never be used as a phrase.
Instead, they argue that doctors should take a more thoughtful approach and say to those closest to the patient, “I’m afraid X is dying.”
For this reason, “fight” and “fight” are listed as banned words, because “patients may feel like they are letting their family down if they don’t recover.”
A doctor can ask a patient’s family ‘what would X want’ if the sick person can no longer communicate.
But the researchers note that ‘want’ is often an ill-defined word in a hospital setting, and what families suspect the patient might want may be impossible.”
Instead, they suggest using “thinking” as an alternative way to meet a patient’s needs, asking family and friends something like “If he could hear all this, what would he think?”
Some patients may wait a long time before finally addressing their illness and seeking medical care, but researchers say the last thing doctors should do is blame a patient and cause even more worry.
So instead of saying to a patient, “I don’t know why you waited so long to come in,” a kinder way to phrase this frustration would be, “I’m glad you came in when you did.”
Likewise, the researchers say that if a new patient visits a doctor with poor results from another doctor, the last thing the doctor should say is “what were your other doctors doing/thinking?”
They explain that this is a negative approach and that it is better to ‘focus on what is still possible.’
They advise: “Take positive next steps, rather than discrediting the professionals whose cooperation you may still need to help the patient move forward.”
Meanwhile, the study authors say that if you ask a seriously ill patient, “Do you want us to do everything?” is not useful.
They say it’s better to invite dialogue rather than “ask a leading question that may not align with the patient’s values or goals.”
Their suggested phrase for doctors is: “Let’s discuss the options available if the situation worsens.”
After presenting their twelve never words and phrases, the researchers concluded: ‘Never words are conversation stoppers.
‘They seize the power of the very patients whose own voice is essential for making optimal decisions about their medical care.
“Physicians should instead strive for dialogue, inviting honest, thoughtful questions and responses from patients and families.
‘They must learn to recognize words and phrases that inadvertently frighten, offend or reduce their agency, and reshape their own communication.
“The beneficial outcome: putting the power back in the hands of patients so they can actively collaborate with their care team to make the best possible treatment and care decisions, and that is what all physicians strive for.”
Last year, Gallup revealed that the share of Americans who rated physicians’ ethical standards highly had fallen from 77 percent at the start of the pandemic in 2020 to 62 percent at the end of 2022 — an unusually steep decline of 15 points in two years.