BMJ 1994;309:1579 (10 December)

Letters

Why care of the dying is still poor

EDITOR,--Mina Mills and colleagues' descriptive analysis of the care of dying patients in four Scottish teaching hospitals highlights an area of medical ignorance or avoidance that still exists 11 years after the study.1 I believe that there are several reasons for this.

Firstly, palliative care is not generally taught in the undergraduate medical curriculum. Like many of their seniors who trained before palliative care became established as a specialty, junior doctors are often unaware of what can be offered to dying patients. This subject is also omitted from most standard medical texts.

Secondly, understandable psychological barriers must be overcome in dealing with dying patients. Doctors often use distancing tactics to alleviate their discomfort and embarrassment to preserve their emotional wellbeing.2 Interviewing, assessment, and counselling skills are needed to enable these patients to be treated openly and sensitively.

Thirdly, when patients do not have cancer the diagnosis of "dying" is often . . . [Full text of this article]


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Relevant Article

Care of dying patients in hospital
M Mills, H T O Davies, and W A Macrae
BMJ 1994 309: 583-586. [Abstract] [Full Text]

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