Doctors, the onus is on you
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different things. Among all deaths the sudden traumatic death of a young person tends to have the greatest impact on the bereaved, who therefore need particularly careful handling. Bereaved people should always be offered the chance to see the body, and generally this should be encouraged. It is an important part of accepting the reality and often helps to dispel the imagined disfigurement. Fact is generally preferable to fantasy, and what right have we to protect bereaved people? The deceased is their relative, and their feelings will tell them what they need to do. We are perhaps just protecting ourselves and hindering them in the process. Seeing the body is also a chance for the people to inspect, touch, hold, kiss, or say goodbye to their loved one. Staff should give permission for these free expressions, as well as allow the chance for bereaved people to be left alone with the body.2 Some may need several visits. Sheila Awooner-Renner was unnecessarily (and cruelly) kept waiting, and when she eventually got to her son she felt inhibited and was watched. There was no need to wait for the coroner's officer. How are we to avoid this well meaning but inappropriate handling of distressed relatives? The hospice movement has led the way, but the acute sector needs a system for coping 24 hours a day. Accident and emergency departments are increasingly recognising the needs of bereaved people, regarding them as unofficial patients (often led by nurses). As well as the senior accident and emergency staff hospital chaplains, social workers, and sometimes bereavement counsellors are available.3 Staff in other emergency specialties, such as intensive and coronary care and neurosurgery, should also have some training and awareness of these matters and be able to integrate their services with those of the hospital and community. Unresolved grief reactions may linger and might be reduced by good, early handling, which should include encouraging the bereaved to express their feelings as they say goodbye to their loved one.
[1] EFFECTS OF ROUTINE ONE-STAGE ULTRASOUND SCREENING IN PREGNANCY: A RANDOMISED CONTROLLED TRIAL , 1988, The Lancet.
[2] S. Thacker. Quality of controlled clinical trials. The case of imaging ultrasound in obstetrics: a review , 1985, British journal of obstetrics and gynaecology.