Views & Reviews Review of the Week

Why doctors need to embrace death

BMJ 2008; 337 doi: (Published 06 August 2008) Cite this as: BMJ 2008;337:a1024
  1. Margaret McCartney, general practitioner, Glasgow
  1. margaret{at}

    A new book finds much fault with how doctors handle patients at the end of life, finds Margaret McCartney

    “Sooner or later there comes a point . . . when the physician realises that he can do no more than ease the terminal stages of life . . . Unnecessary investigations or surgical interference should be eschewed, and the doctor ought to concentrate on alleviation of distress rather than systematic treatment.” So wrote Trevor Howell, deputy physician and surgeon, of the Royal Hospital, Chelsea, in 1944 in Old Age: Some Practical Points in Geriatrics. I am in the habit of reading old medical textbooks, because sometimes they help to explain how we came to end up where we are. What they do not always explain is why.

    The palliative care movement sometimes sells itself as something new and original—the idea that comfort can and should sometimes replace cure. Yet old books can also tell of …

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