Career Focus

Palliative medicine

BMJ 1999; 319 doi: (Published 24 July 1999) Cite this as: BMJ 1999;319:S2-7204

It is a fact of life that we all must die, hopefully as peacefully and comfortably as possible. The specialty dedicated to achieving this is expanding, writes Marie Williams

  1. Mari Lloyd-Williams, specialist registrar in palliative medicine
  1. Leicestershire Hospice, Leicester LE3 9QE

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    Although a young specialty, palliative medicine is now the 11th largest and one of the fastest growing, but still many people shrug their shoulders when asked what we do. After three and half years in post, I still get letters from the university addressed to me at the “Department of Palaeontology Medicine.” The word palliative is derived from the Latin “pallium,” which means to cloak or hide. Palliative medicine is the specialist care of patients who have a life threatening, incurable illness, with the aim of treating their symptoms so that they can live their remaining life as comfortably as possible. Despite many changes in medical education we still do not train new generations of doctors to deal with the reality of progressive chronic illness.

    What is it?

    Palliative medicine encompasses a wide range of skills, both intellectual and people centred - the palliation of physical symptoms is a large part of the work, but the holistic care of patients includes their psychological, social, and spiritual wellbeing. This care often extends after the death of a patient to the bereaved relatives and friends. It provides an opportunity to work with medical colleagues in all specialties and with general practitioners and a wide range of paramedical staff. These close working relationships are often fostered by the shared care of individual patients and by the sharing of knowledge and skills. Some of the most challenging aspects of the work involve supporting patients and families in ethical decision making, often in highly charged emotional situations, and there is a need for considerable diplomacy.

    Historically, specialists in palliative medicine largely worked in hospices - independent units often funded by the local community - but consultants now have an increasing role in hospital symptom control teams and …

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