Views And Reviews

Patients' sense of completion

BMJ 1994; 308 doi: (Published 25 June 1994) Cite this as: BMJ 1994;308:1722
  1. R Morrison

    Once upon a time when people gave up the ghost that was it. Now they are at serious risk from the enthusiastic bystander keen to pummel the ghost back into the body. If you want to die choose your place of departure with care. Even castaways will soon find life support machines already installed with resuscitation officers on call to parachute in. This is great if it is what you want but not if you do not.

    Resuscitation is the prolongation of life at its most dramatic. Hippocrates would have cheered. Or would he? I have observed a more subtle version of the Hippocratic tradition that is far more worrying. This is to be seen in wards where the elderly are being cared for. From antibiotics to tube feeding, the professionals have an armamentarium of treatments to keep the very old and infirm alive a few days longer. Fair enough, if this is what the patient wants. But how often are the doctors right in their judgment of what the patient wants? How often are they swayed by thoughts of dissatisfied relatives or predatory lawyers? Their Hippocratic oath states that a doctor should do no harm …

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