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"Am I Dying Doctor?": How End-Of-Life Care is Portrayed in Television Medical Dramas

Carmen HM Houben, Martijn A Spruit, Emiel FM Wouters, Daisy JA Janssen

Background: Patient-clinician communication about end-of-life care is important for patients with chronic lifelimiting diseases and their loved ones but requires engagement from patients and loved ones. Television is a powerful medium in influencing people’s behaviour. However, it is unknown which image is sketched on television about end-of-life care communication. Objective: To explore communication about end-of-life care between healthcare professionals and patients or loved ones in popular medical dramas on television. Methods: 68 episodes of television medical drama were reviewed (22 episodes of House, 22 episodes of ER, and 24 episodes of Grey’s Anatomy). Three types of events were identified: communication between healthcare professionals and patients or loved ones about end-of-life care, cardiopulmonary resuscitation (CPR), and death. Results: In total, 99 events of end-of-life care communication, 47 events of CPR, and 27 events of death were observed. Discussions about end-of-life care were mostly initiated by physicians in the presence of patients and loved ones. The most frequently addressed topics were: talking about the possibility of dying, treatment options, and life-sustaining treatments. The immediate success rate of CPR was 51.1%. Of the patients who deceased, the majority died unexpected, usually a life-prolonging treatment was performed before death, and advance directives were uncommon. Conclusion: Healthcare professionals in television medical dramas talked with patients or loved ones about endof- life. However, topics important for patients in real life were often not discussed.