"It's All My Fault": Responding to Patient Self-Blame in Serious Illness Care.

J Palliat MedNov 14, 2025 (epub)
Case ReportOncology (Medical)Internal Medicine (General)

John Wagner, Terra Solove, Julia H Vermylen et al.

✦ AI-curated · Sources linked

Case in brief

A 61-year-old woman with metastatic rectal cancer attended a palliative care visit to discuss imaging that showed disease progression. After taking in the news, she said that her illness was harming her family and that it was all her fault. The team considered how to respond. The case highlights the risk of moving too quickly to reassure her that she had done nothing wrong; instead, the discussion emphasizes acknowledging the emotion and exploring what underlies it.

Diagnostic / clinical pearl

When a patient expresses self-blame, avoid reflexively correcting or reassuring. Acknowledge the emotion and explore its origins to better understand the patient’s concerns and priorities.

Why it matters

Self-blame can be difficult for clinicians to hear, but trying to quickly resolve it may dismiss the patient’s distress and limit understanding of what matters to them.

Source

PubMed · PMID 41269083

Published in J Palliat Med. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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