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Editor's Choice

Changing attitudes, improving lives

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l1026 (Published 07 March 2019) Cite this as: BMJ 2019;364:l1026

Re: Changing attitudes, improving lives

Of the few situations in medical practice , ill understood or misunderstood and poorly comprehended / interpreted , both by patients / attending relatives and often by medical fraternity members themselves are the twosome - palliative care and EoLC (end of life care ). Conventionally trained to do the best till the 'last' , anything 'less' or 'withdrawl in some form - drugs , devices , equipment ' may be construed as compromise ,retreat , surrender and defeat , often with a feeling of apprehension and guilt. The decision has to be clinically dictated , situationally considered and ascertianed , adequately counselled. Expectations of improvement , posotive outcome and recovery from the patient and relatives can be unrealistic , what with medical feats appearing regularly in the lay media. Finally humanity survives on hope and doctors need to know that hopes in the worst clinical scenarios can be 'eternal '. Rebranding may not be a wise step to undertake ; clarity of concepts for both the sides , sound understanding , correctness on timing of the clinical decision to palliative care and overall social approval appear to be prerequisites necessary for making life and survival bearable and the inevitable acceptable. Dr Murar Yeolekar, Mumbai.

Competing interests: No competing interests

09 March 2019
Murar E Yeolekar
Professor & Head , Dept. of Internal Medicine
K J Somaiya Medical College and Hospital
Eastern Express Highway, Sion, Mumbai 400022.HEaC