Tag Archives: service

I think therefore I am? – Who does health information belong to?

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Photo by Wesley Tingey on Unsplash

This was a question that came to mind after a past colleague theorised about changing a patient’s prognosis to more than six months left to live to stop them from accessing the assisted dying service. I was shocked that they would consider doing something like that. In plain English, it would be telling a lie. Lying to a patient and not giving them your true medical opinion. An opinion that required at least 13 years of training to develop, but one they could consider defiling by not telling the truth. To me, this was wrong on many levels and was one of the main reasons I didn’t miss the ex-colleague much.

Honesty is something our patients deserve. We need to let them know what is going on to the best of our abilities. We are not fortune-tellers and we cannot predict the future but we can provide our best educated guess. People usually want to know how much time they have left as it puts a lot of things into perspective. It makes them focus on what is really important to them. Who is important to them, and who they want to spend their precious time with. What things do they still need to complete given the limited time left? Where they draw the line. What is too much for them to handle? To rob them of these opportunities is wrong.

A person’s prognosis is not owned by the doctor, it is the patient’s prognosis, not their family’s, or their parents’ or children’s. It is their own prognosis. They can do what they like with the information. It is their property and can be used as they see fit. To deny someone the truth about their end of life is such a bad thing to do. You might not agree with what a patient, or what another person chooses, but that does not give you the right to sabotage their plans. They have already lost so much control of their life and a so-called professional would try to stop them from attaining a dying wish.

We are supposed to provide patient-centred care, not doctor-centred care. We exist to serve our patients. They do not exist just to provide us with work, they have lives of their own, stories of their own. It is not about us. Palliative care is supposed to be focused on the needs of the patients and not the needs of the providers. Anything else is just wacko.

I think therefore I am? – Hearts and Minds

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Photo by Jon Tyson on Unsplash

To do palliative care and hospice well your heart does need to be in it. People can easily tell if you are not really there. It doesn’t have to be as obvious as someone who won’t sit down, or who constantly checks the time on their watch. Do you have somewhere more important to be at the moment, than in my room? Something more important that needs to be done than listening to me?

If someone’s heart isn’t really in it people can tell right away. The lack of attention that is paid to simple things. So we do want people to be engaged to actually care for people. It does need to be done professionally, with kindness and respect. People need to have firm boundaries that they do not cross. It’s about protecting yourself and also the person that you are working with. You can be friendly but cannot be their friend. You can be caring but it must be in a professional manner. We are guests in their lives, and we do not want to disrupt pre-existing relationships.

We are involved possibly in the final chapter of someone’s book of life. It is not about us, but about them. They are the stars of their own show, of their own movie, of their own stories. We are only extras, or play a tiny bit part. We may have only a few lines to say, and we will try to say them well. The direction of the story needs to be guided by the person going through it all. We would not be in the same room as them if they were not sick, if they did not need the care that we can provide. We must never forget that, that they are not here because of us, but that we are all here because of them. The patient needs to be at the centre of everything that we do, not their family members or friends but the actual person themselves.

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