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Doctors fighting, fleeing, or facing up to death

BMJ 1998; 317 doi: (Published 01 August 1998) Cite this as: BMJ 1998;317:355
  1. Janet Goodall, retired consultant paediatrician
  1. Stoke-on-Trent

    It can be disturbing to consider medical practice as portrayed by the media. On the one hand, we hear of living wills, intended to forestall artificial prolongation of dying. On the other hand,incurable patients—and parents of incurably ill babies—are sometimes finding doctors who will hasten death. If these extremes are there how do they arise?

    My reflections about this were fuelled when three of my good friends died within a two week period. In their dying, they showed some of the emotional reactions to loss which doctors can so readily identify in others while imagining themselves to be immune.

    The non-medical friend, dying several months after surgery for ovarian cancer, had never admitted to declining health but kept speaking hopefully of improvement ahead. One of the doctors, with inexorably worsening cerebellar ataxia, had rejected offers of palliative therapy, fearing stupefaction. Instead, too unsteady to act for herself, she repeatedly asked her general practitioner andher husband …

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