Palliative care in terminal cardiac failure

doi:10.1136/bmj.310.6991.1410b

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Hospices cannot fulfil such a vast and diverse role

Craig Gannon

Staff grade doctor in palliative medicine Myton Hamlet Hospice, Warwick

EDITOR,—I agree with Sarah Jones's comments about the neglected needs of patients with terminal cardiac failure1 and the fact that the poor prognosis is not appreciated as being the same as that in cancer.2 Ironically, this benefits patients with cardiac failure, who are spared the taboos of cancer, its particular stresses, and thedistancing of health professionals. The infrequency of requests to hospices regarding cardiac failure could reflect the ability and willingness of hospitals and primary care teams to continue care. The original need for hospices was to redress this imbalance.

Palliative care for all is an admirable goal, and palliative medicine's …