The burden of the conversation
The healthcare professionals mentioned that the conversations can be
complicated. It can be complicated because sometimes there is adiscrepancy or dissension of ideas between the doctor and the
patient. “In some situations, I have the idea that what you do is
never actually good. Because sometimes, when a patient dies, that is not
what the family wanted. But also, when someone survives the ICU but with
a low quality of life, it is also not what the family wanted”
[Interview 7]. The healthcare professionals also indicated that
there are situations where there is a disagreement with the patient
about the treatment limitation. In some cases this leads to a certaincommotion . “Yes, I have also been accused of not wanting
to treat someone anymore or something… helping someone more towards
death…” [Interview 5]. Cultural difference is also a subject
that has been mentioned by the healthcare professionals as being
difficult sometimes. Some families, because of their religious beliefs,
do not want to give up treatment. Instead they want to do everything
that is possible to prevent the patient from dying even though in some
cases this is medically irresponsible in the professional’s eyes. This
can lead to differences in opinion and unpleasant situations.“There are also transcultural problems, that we as doctors think
that it is better if the patient doesn’t go to the intensive care, but
the family is pushing us to do so, regardless of the situation of the
patient. These are difficult situations…” [Interview 7].Healthcare professionals also indicated that the conversations will be
normalized for patients as long as they are consequently performed.