Responding to unexpected events

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7422.1049 (Published 30 October 2003) Cite this as: BMJ 2003;327:1049

Maybe skills for this case were missing

  1. W Noel Brown (nbrown{at}nmh.org), chaplain supervisor
  1. Northwestern Memorial Hospital, Chicago, IL 60611, USA

    EDITOR—Saunders et al describe a difficult and sad case, something of which they were very aware.1 As a non-medical healthcare professional I was acutely aware of the absence of certain aspects of care in the case history.

    No description is provided of the technically difficult task of sitting with this man at midnight to help him decide what he wanted in this situation, to help him in making a choice about the course of action that would be consistent with his values and wishes. In the United States clinically trained chaplains and social workers provide this kind of technical care. It entails skills that are not taught in every medical school curriculum.

    If patients are to “retain control of their environment and destiny” they need the skills of others who have been trained to help people do that. It is not always doctors who have best been prepared to do this. Benefits are to be gained by having a non-doctor function in that role.


    • Competing interests None declared.


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