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End-of-life Issues & Humor


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Abstract (emphasis added): Patients' use of humour in discussing sensitive end-of-life issues. Sub-category: End-of-Life Care. Category: Patient Care. Meeting: 2008 ASCO Annual Meeting. Abstract No: 20552. Citation: J Clin Oncol 26: 2008 (May 20 suppl; abstr 20552). Author(s): I. N. Olver, J. Eliott.

Background: The use of humour has been reported as a strategy for countering existential ambivalence or normalising difficult situations such as serious illness and its treatment, and as part of coping with them. Its use has also been associated with reduced anxiety and depression. We therefore expected that humour would be used as part of communication about end-of-life issues.

Methods: Taped semi-structured interviews with 51 patients (27 females and 24 males) with all stages of cancer who were being interviewed to obtain their views of end-of-life decision-making in order to inform policy (Olver et al., Psycho-Oncol 2002, 11(3): 181-187, Eliott et al, Qual Health Res 2007; 17(4): 442-455) were analysed for the use of humour in discussing sensitive issues. Reading and rereading and a qualitative software package were employed to sort the interviews into categories, and for this study speech associated with laughter was analysed.

Results: When specifically referring to humour patients indicated its importance for them to "lighten the atmosphere" but also indicated that the use of humour was a desirable attribute of their doctors. There were 5 broad categories where patients used laughter. The most common was when they were uncertain about an answer (e.g. the ideal timing of discussing 'do not resuscitate orders' with patients). The others included when embarrassed at discussing personal or family issues or physical symptoms, or when making rash generalisations. Patients laughed when they purposely told amusing anecdotes or used colloquialisms for sensitive concepts like death, as well as laughing in response to humour expressed by the interviewer. The topics discussed that were most associated with patients' use of humour were death, euthanasia, funerals (particularly their own), hope, religion, and when patients described complementary and alternate therapies.

Conclusions: Patients utilise humour to help discuss issues that they find stressful or embarrassing such as those associated with end- of-life decision-making and it is important to create an empathetic environment in which this can occur to assist them in expressing their views.

Source: http://www.asco.org/ASCO/Abstracts+%26+Virtual+Meeting/Abstracts?&vmview=abst_detail_view&confID=55&abstractID=31502

Submitted by Carole

Life does not cease to be funny when people die any more than it ceases to be serious when people laugh. —George Bernard Shaw

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humour was a desirable attribute of their doctors

Reminds me of another Larry story.

When Larry was going through his chemo for non-hodgkin's lymphoma, we noticed a trend when Larry talked with his doctor:

If Larry told the doctor a joke, he would look puzzled and leave the room. Minutes later, we would hear him laughing down the hall. Then, we would get a bill for an "intermediate visit" as opposed to a "brief visit".

I told Larry that he really needed to stop telling jokes to that doctor. It was costing us a fortune!

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My medical oncologist has a unwarranted reputation at th clinc for being evil. She is absolutely not that. I just call myself her evil patient. She laughs at me pretty much during are entire visit...not sure exactly what I do to entertain her but I do. And laughing brings my blood pressure down as well. Who would have thunk one might actually have fun in an oncologists's office talking about LC! Makes it bearable though.

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