Doctors probably have one of the hardest jobs in the world. Not only do they need extensive medical knowledge in order to treat their patients, but when a patient dies, they have to convey the bad news to their families. Telling a family that their loved one has died can be extremely difficult. That said, would it be helpful if the medical institutions involved regulated these condolences?

Currently, most doctors opt to write condolence letters to the families of deceased patients, but the practice is entirely personal and unregulated. And according to Dr. Naveen Vasudev, a doctor at St. James’s Institute of Oncology and a researcher at the University of Leeds, writing condolence letters is a practice that has rarely been studied or discussed in the medical field.

"I was reflecting on my own practice, and I became aware that my colleagues all seemed to be doing different things when expressing condolences," said Dr. Vasudev in a press release. "So, we thought it would be interesting to document this variation and try to understand the underlying reasons."

To start the conversation, Dr. Vasudev and his research colleagues decided to survey local doctors about their opinions regarding condolence letters. The survey asked whether or not medical institutions should make condolence letters more official, and it was administered to 47 oncologists and palliative care consultants. The doctors’ responses spoke very strongly against further regulation, and they were insistent on keeping the practice as personal as possible.

"The doctors in our survey felt strongly about when and how they wished to express their condolences to bereaved relatives," said Jessica Hayward, one of the study’s co-authors and a medical student at the University of Leeds. "Trying to make the practice more uniform may be seen as a good thing, but this doesn't seem to be appropriate or feasible."

Regulating condolence letters could ensure that all families receive adequate and helpful letters, but this belief was not shared by the doctors. Seventy-two percent stated that they were not in favor of introducing new policies to standardize condolence letters.

One doctor who took the survey commented, "Condolence letters are a matter of professional discretion and judgment and should not become a 'policy.'" Other doctors wrote that every letter needs a personalized touch; otherwise, families could be hurt if they perceive their doctors to be indifferent to their loss.

"This is a small study, with lots of scope to build on these initial results," Vasudev said. "It would be interesting to document practice on a much wider scale, both increasing numbers and also perhaps to include other specialties beyond oncology and palliative care.”

All of the doctors included in this survey were from the Leeds area in the UK, where the researchers say the cultural practices surrounding grief are often very private. In other areas, doctors may be more supportive of new regulatory policies.

“It would also be important to find out the views of bereaved relatives themselves," Vasudev said.

Though further research would be required to get a better sense of doctors’ opinions as a whole, this small study was crucial for beginning the conversation. Hayward concluded that he hopes the research will inspire doctors “to think about this issue, and to reflect on their own current practice following the death of a patient.”

Source: Hayward JS, Makinde O, Vasudev NS. Letters of condolence: assessing attitudes and variability in practice. ecancermedicalscience. 2016.