Journal of Bioethical Inquiry

, Volume 9, Issue 4, pp 439–441 | Cite as

The Importance of Patient–Provider Communication in End-of-Life Care

  • Timothy R. Rice
  • Yuriy Dobry
  • Vladan Novakovic
  • Jacob M. Appel
Symposium

Abstract

Successful formulation and implementation of end-of-life care requires ongoing communication with the patient. When patients, for reasons of general medical or psychiatric illness, fail to verbally communicate, providers must be receptive to messages conveyed through alternate avenues of communication. We present the narrative of a man with schizophrenia who wished to forgo hemodialysis as a study in the ethical importance of attention to nonverbal communication. A multilayered understanding of the patient, as may be provided by both behavioral and motivational models, can inform the provider’s ability to receive, process, and represent communicated content to the patient or his or her surrogate decision-maker.

Keywords

End-of-life care Therapeutic alliance Capacity Surrogate decision-maker Renal failure Dialysis Consent Moral responsibility Physician duty 

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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Timothy R. Rice
    • 1
  • Yuriy Dobry
    • 1
  • Vladan Novakovic
    • 1
  • Jacob M. Appel
    • 1
  1. 1.Department of PsychiatryThe Mount Sinai Medical CenterNew YorkUSA

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