When is palliative care not enough

There is also over 40 years of research evidence which shows how difficult it is for doctors to accurately predict how long a patient has left to live, typically overestimating survival. Research has found that the longer a doctor has known their patient, the more likely they are to be overoptimistic about their likely survival.

Oncologists are treating their patients for longer than ever before — it is not unusual to treat a patient with incurable breast cancer for seven to ten years. And as patients show variable responses to the increasing treatment options, the odds are stacked heavily against doctors being able to master the elusive art of accurate prognosis any time soon. To try and improve conversations and ideas around palliative care, we are now undertaking another study which aims to improve patient understanding of palliative care and equip doctors with the skills and confidence to start these challenging but crucial conversations earlier with their patients.

Festival of Social Science — Aberdeen, Aberdeenshire. Edition: Available editions United Kingdom. Euthanasia is not a substitute for palliative care. Good-quality palliative care is not going to work for everyone, just as heart surgery is not per cent successful. But for the majority, a palliative care experience is a good one. Doctors need to take some responsibility as well. Palliative care is a small part of general medical training; we tend to focus on the saving and not enough on the right time to let someone go.

Palliative care is not only resisted by patients who see it as an end game, but their doctors, who see it as a failure. It is neither of those. In palliative care we often help patients and their families come to terms with what is happening to them, perhaps we need to sit with their doctors as well. We all need to talk more about death being a natural part of life. Maybe then we will be better equipped to enable people who are dying to get the best out of any time they have left.

The best chance they have of achieving that best-case scenario, is giving them access to good-quality palliative care. Euthanasia is a very complex ethical debate that should happen well after we have achieved that. If you have any stories or ideas to share with us, send us an email. I had to tell my dad that, based on my research, he had maybe months. Many terminally ill patients are under the care of palliative teams as well as their GP. This means that they are offered help to manage problematic symptoms such as pain, nausea, breathlessness or agitation.

Patients and families can access support through their local hospice, and district or Marie Curie nurses. But end-of-life care is patchy across the country, with a need for greater investment to reduce health inequalities, particularly as more and more people with often complex sets of symptoms are dying at home.

The bill talks about patients who are expected to die within six months, but not others who are severely ill with prolonged debilitating conditions, and wish to die. However, not everyone who we would deem to have a poor quality of life wishes to die. I have seen patients who are paralysed, tube fed, catheterised and with no hope of recovery. Yet they still find their lives worth living. There is the real possibility of coercion — whether implied or expressed — by friends, family and even health professionals when patients are seen to be a burden.

There have also been recorded cases of patients administering their prescribed lethal medications three years after being prescribed them. To force someone to suffer against their wishes and endure a drawn-out death is torture. This is not acceptable in a civilised society. In my view, a change in the law to allow assisted dying in limited circumstances and with robust protections is the only appropriate response to the findings of this report.

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