Why Are We Doing This?”: 

Journal of Palliative Medicine

To cite this article:
Back Anthony L., Rushton Cynda H., Kaszniak Alfred W., and Halifax Joan S.. Journal of Palliative Medicine. January 2015, 18(1): 26-30. doi:10.1089/jpm.2014.0115.

Published in Volume: 18 Issue 1: January 2, 2015

Author information

Anthony L. Back, MD,¹ Cynda H. Rushton, PhD,² Alfred W. Kaszniak, PhD,³ and Joan S. Halifax, PhD⁴

¹Department of Medicine, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, Washington.

²Berman Institute of Bioethics; School of Nursing & Medicine, Johns Hopkins University, Baltimore, Maryland.

³Department of Psychology, University of Arizona, Tucson, Arizona.

⁴Upaya Institute, Santa Fe, New Mexico.

Address correspondence to:

Anthony L. Back, MD

Seattle Cancer Care Alliance

825 Eastlake Avenue E

Seattle, WA 98102

E-mail: tonyback@uw.edu

Accepted October 5, 2014

ABSTRACT

Background: When the brutality of illness outstrips the powers of medical technology, part of the fallout lands squarely on front-line clinicians. 

In our experience, this kind of helplessness has cognitive, emotional, and somatic components.

Objectives: Could we approach our own experiences of helplessness differently? Here we draw on social psychology and neuroscience to define a new approach.

Methods: 

First, we show how clinicians can reframe helplessness as a self-barometer indicating their level of engagement with a patient. 

Second, we discuss how to shift deliberately from hyper- or hypo-engagement toward a constructive zone of clinical work, using an approach summarized as “RENEW”: recognizing, embracing, nourishing, embodying, and weaving—to enable clinicians from all professional disciplines to sustain their service to patients and families.