Barriers to end-of-life discussions among hematologists: A qualitative study:

Background:Integrated palliative care is correlated with earlier end-of-life discussion and improved quality of life. Patients with haematological malignancies are far less likely to receive care from specialist palliative or hospice services compared to other cancers.Aim:The main goal of this study was to determine hematologists’ barriers to end-of-life discussions when potentially fatal hematological malignancies recur.Design:Qualitative grounded theory study using individual interviews.Setting/participants:Hematologists (n = 10) from four hematology units were asked about their relationships with their patients and their attitudes toward prognosis and end-of-life discussions at the time of recurrence.Results:As long as there are potential treatments, hematologists fear that end-of-life discussions may undermine their relationship and the patient’s trust. Because of their own representations, hematologists have great difficulty opening up to their patients’ end-of-life wishes. When prognosis is uncertai...