Observations Ethics Man

Matters of life and death and quality of life

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e775 (Published 01 February 2012) Cite this as: BMJ 2012;344:e775
  1. Daniel K Sokol, honorary senior lecturer in medical ethics, Imperial College London, and barrister, Inner Temple, London
  1. daniel.sokol{at}talk21.com

Hospital doctors hold no monopoly in dealing with matters of consequence

Some doctors deal with matters of life and death on a regular basis. If the cardiac surgeon ignores the leaking aneurysm, the patient will die in minutes. If the anaesthetist fails to intubate at once, the patient will asphyxiate. In an emergency department in the United States I was present when a patient shot through the back was admitted by helicopter, his chest opened up within seconds of landing, and his heart pumped manually by a trauma physician. It was impressive, high octane medicine. In the course of a recent conversation with one of those life and death doctors, I lamented the plight of a young woman who had lost a leg in a road crash. Her life had been forever changed. She could no longer do things that we take for granted, such as swimming or taking the train or wearing certain clothes. The doctor remarked, to my surprise, that, though regrettable, “it wasn’t a matter of life and death.”

This dismissive attitude …

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