Consoling the Grieving: Palliative Bereavement Care and the Ethics of Support Conversations
Friday, October 13, 2023
9:30 AM – 10:45 AM ET
Location: Galena (Fourth Floor)
The current paradigm for bereavement support in palliative care is empathic listening, where providers elicit emotions of the grieving person through open-ended questions, communicate support, and attempt to normalize the person’s feelings and behaviors (Crowe and McDowell 2017; Walker 2010). I argue that clinicians can supplement this paradigm and further alleviate suffering by consoling their patients. I will distinguish consolations—remarks that attempt to relieve fear and anxiety concerning death or the loss of a loved one—from the empathic listening paradigm. While not simply empathically listening, consolations are nonetheless consistent with that approach and could further reduce the suffering caused by grief. I provide an ethical framework for how to do this in a way which is responsive to the beliefs and values of the particular patient and family. Clinicians attempting to console grieving patients should have 1) sufficient indication of patient openness to consoling conversations, 2) evidence of significant need for emotional support, and 3) background knowledge that particular ideas or suggestions would be consistent with the underlying values of the loved ones they are directed to. This context-sensitive approach has the advantages of the empathic listening paradigm but could be better at reducing suffering than the currently dominant approach. Finally, I consider and respond to two objections to consoling in clinical practice.