Letters Palliative care and multimorbidity

Palliative care for all?

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e7628 (Published 13 November 2012) Cite this as: BMJ 2012;345:e7628

Re: Palliative care for all?

A very apt response from Dr Anthony-Pillai, though the "new mantra" has existed for over 2000 years. Hippocrates - "to cure sometimes; to treat often; to succour always" (quoted also by Dr Murray in her Personal View on p.34).

Medical Science probably never cures in fact. How many treatments restore the body to its previous condition? The surgeon who removes a diseased organ leaves scars in multiple tissues (and a deficiency of that organ). All medical treatments bring significant risk (e.g. the risk of injections as well as drug side-effects). Cancer "cures" leave an impaired immune system. Antibiotics appear to "cure" but they are probably simply reinforcing the body's own (better) defences.

As Dr Murray's article implies, all doctors (perhaps all health professionals and ancillary staff) are engaged in palliative care, and all should have some grasp of principles in terminal care.

I have never seen it enunciated, but it always seemed obvious to me that terminal care in the final months of life must necessarily compel urgent attention to other intercurrent discomforts (e.g. sorting out the hernia, the prostate, or the arthritis). Indeed, when it is evident it is a "quick fix" treatment can sometimes be easier.

That this discussion is occuring at all concerns me. Some health professionals seem to have lost a grip on the obvious.

Competing interests: No competing interests

20 November 2012
Nicholas P Hudd
Consultant Physician
Tenterden TN30