How to tell a family that their loved one has died

by Tim Noonan

When a team misses out on an opportunity to go to the Super Bowl, World Series, Final Four, or something similarly trivial, these words may be appropriate. When the person, who has been the center of your life dies, what is more insensitive than, We’re sorry for your loss?

What kind of language is that to use when providing some of the worst news we could imagine? True, we could try to be insensitive and say something like, Sucks to be you, but I am assuming that the goal is not to demonstrate a lack of compassion, or a lack of sympathy. At least not intentionally, still these are lacking.

Compassion and sympathy mean to share feelings with another. In this case, to share suffering with another. We don’t want to suffer and we do not want them to suffer. We’re sorry for your loss is only a way of deflecting a suffering we hope never to know. The death of someone we love may not be the worst experience of our lives, but the unexpected death of someone young has little competition for the worst experience.

When my father died, I had known it was coming for years. He had his defibrillator turned off several weeks before. Apparently an arrhythmia was the cause of his sudden, but expected, death. He could not have planned it much better. My mother called me, and I talked her through confirming that my father really was pulseless. I reassured my mother that this was what he had repeatedly said that he wanted. She could call the funeral home in the morning. By then, even the most aggressively insensitive EMS people should be able to realize that he is beyond treatment. I told her to get one of the many DNR forms that I had placed all over the house, in her pocketbook, and in his wallet.

An ideal death. 82 years old. No signs that his death was painful. No unnecessary treatment was inflicted on him to satisfy any bureaucratic sadism. We should all be so lucky. These are the deaths that are the easiest to deal with. It is difficult to mess up this death notification, since everybody already knows.

However, it is with the unexpected death that we seem to go out of our way to be insensitive. When someone dies, we use words that attempt to hide what happened. We lie. As if that lie will make the suffering go away. We aren’t trying to be insensitive, but that does not keep us from insensitive behavior.

Telling a young mother that her 3 month old has gone to a better place is just telling a lie in order to avoid using the word dead.

Telling a couple of parents that their teenager has passed on is also just telling a lie in order to avoid using the word dead.

What about death brings out this kind of abuse? We can break the news gradually, but giving someone false hope through these lies is cruel.

I like to start by asking if they know what is going on and letting them guide me to the right way to break the news to them. Many will ask directly. They almost never use euphemisms, although they may now be hoping for something that was unthinkable just a little while before – jail, or just an amputation, but not dead. The person may be in a better place, but the word that needs to be used is dead.

We need to make it unmistakably clear. The simplest way to do that is to use the word dead. It is the truth. We need to stop telling lies, just to help us feel better. This isn’t about us.

In medicine, meaning well does not keep us from making a bad situation worse.

Tim Noonan is a paramedic who blogs at Rogue Medic.

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