Quote from nosonew
Her husband died after a very short battle with cancer. The oncologist told them due to his liver function that chemo would kill him, but he did do radiation. However, the cancer spread and within 3 months he died. They were just about to retire and travel. Now, the wife is very angry, making threats against the oncologist, stating he didn't give them the option to do chemo and it was their right to choose. She has called the oncologist and written him letters. She talked to our bereavement counselor once, then told him he should look at a different line of work. She refuses to see a therapist.
Is it appropriate to call her grown sons and voice my concerns without giving out all of the info? I am really concerned about her and also just found out her youngest son was just diagnosed with cancer. And her mother is dying. I don't think she can take anymore.
What to do????
I am taking care of her mother and I also took care of her husband during his last weeks, so I have met the sons.
Personally, I wouldn't.
There ARE stages of grief and anger is one of them. It seems she is stuck at that point, and while you might be correct that she needs some help to get past that, I don't think it's wise for YOU to intervene.
Here's my concern: she's looking to 'blame' someone for her husband's death. You pointed out TWO healthcare professionals that she has displaced her anger towards. You risk becoming the third.
And you risk it with the very real possibility of doing something that can be exploited to actually penalize you: violating HIPAA. Worse, because your concerns are in regards to someone whose relationship towards you in these matters ended with the death of YOUR pt, you risk a very murky view of obligations.
If you are extending yourself beyond your formal professional relationships to meet such obligations, can't it be reasonably argued that you are extending your professional obligations to encompass such needs? Wouldn't that make you professionally responsible for the failure of such needs to be met?
Professional Liability requires four components: have an obligation, fail to meet that obligation, harm results, the harm is directly related to the failure.
As far as HIPAA, notifying her sons can be a direct violation of professional liability, meeting enough of those requirements that any inquiry into your behaviour could cause professional sanctions.
More importantly is the first requirement. If you extend such professional obligations, you CREATE the pathway that leads to such liabilities.
There are no easy answers. But, from a PROFESSIONAL standpoint, this is beyond your ability to easily address WITHOUT extending that relationship past professional boundaries. The healthcare system IS trying to address it, hence the grief counselor. And you yourself have pointed out how well that worked.
Personal morals and ethics are not always the same as professional ones. This is why we try to define our professional boundaries. Those professional boundaries protect us, in more ways than one.
I just don't think I'd cross those boundaries in this case, at all. If she is not accepting the help that IS being professional offered, she will likely NOT accept the help that comes from outside effort on your part, and she might well hold it against you for even trying. That IS the problem - that is where she is stuck.
I would address it with her during your interactions w/ the care of her mom and I would make sure she knows what resources are available to her. And, IF her sons show during the care of mom, and IF you can talk to them, I would make sure THEY know about such resourses.
Other then that, I'd try to marshall the resources available to her while she is there for her mom. But, I do so WITHOUT solely taking on such obligations. That's why we have a multi-disciplinary team.