End-of-life essentials: a question of ethics

Discussion with doctors addressed four distinct areas in providing quality EOLC during the national events. These included the assessment of patients’ mental capacity, pain relief, the detection and treatment of depression, and providing patients with a prognosis regarding life expectancy. On account of the inherent difficulties in giving accurate timescales for life expectancy, particularly in the medium to long term, many doctors felt uncomfortable about the prospect of having to give uncertain answers or risk failing to meet a patient’s request.   Emotional support For many doctors, a terminal diagnosis and the commencement of EOLC initiates a fundamental shift in the doctor-patient relationship, from one of simply providing treatment to a more intimate interaction involving emotional support and mediation. Even so, responses to the study revealed that very few doctors claim to have had any training in discussing death and the dying process with patients, with many doctors having to develop these skills ‘on the job’. Dr Bell says that for most doctors, discussing end-of-life care with a patient for the first time was hard, but that confidence and training played a vital role — a factor that medical schools are now much more aware of. She adds: ‘It is hard when you’re a GP and you’ve known a family for many years. You will have your own feelings when a patient receives a life-limiting diagnosis.’ Assessing a patien...
Source: BMA News - Category: UK Health Source Type: news