Rapid responses are electronic comments to the editor. They enable our users
to debate issues raised in articles published on bmj.com. A rapid response
is first posted online. If you need the URL (web address) of an individual
response, simply click on the response headline and copy the URL from the
browser window. A proportion of responses will, after editing, be published
online and in the print journal as letters, which are indexed in PubMed.
Rapid responses are not indexed in PubMed and they are not journal articles.
The BMJ reserves the right to remove responses which are being
wilfully misrepresented as published articles or when it is brought to our
attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not
including references and author details. We will no longer post responses
that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
As an out of hours GP I am often thrown into terminal care situations
with no knowledge of the patient. As an experienced GP I can usually tell
that "the end is nigh" but that is not the whole story. Then the
"politics" starts. Sometimes the family are not aware of how an attending
GP might manage this situation. I have to very careful that my treatment
decisons are not seen as the main reason life ended. As a relatively
annonymous doctor I would be an easy target for misunderstanding. I might
admit to hospital if I did not feel I was able to "sell" my home treatment
to the family. If the patients own GP prepares the family and patient for
the likely events as the end nears, then my job is easier. I am not
generalising and families usually are more than happy to continue home
management once there is adequate discussion of what is trying to be
achieved. Usually families have also been prepared well by the GP and
palliatIve care services. However there are occasions where admission is
necessary to cover my back as a complaint of ending a life prematurely can
have serious affects on professional and personal lives.
Preparatory work is all
As an out of hours GP I am often thrown into terminal care situations with no knowledge of the patient. As an experienced GP I can usually tell that "the end is nigh" but that is not the whole story. Then the "politics" starts. Sometimes the family are not aware of how an attending GP might manage this situation. I have to very careful that my treatment decisons are not seen as the main reason life ended. As a relatively annonymous doctor I would be an easy target for misunderstanding. I might admit to hospital if I did not feel I was able to "sell" my home treatment to the family. If the patients own GP prepares the family and patient for the likely events as the end nears, then my job is easier. I am not generalising and families usually are more than happy to continue home management once there is adequate discussion of what is trying to be achieved. Usually families have also been prepared well by the GP and palliatIve care services. However there are occasions where admission is necessary to cover my back as a complaint of ending a life prematurely can have serious affects on professional and personal lives.
Competing interests: None declared
Competing interests: No competing interests