Editor—How sad it is, that in 2003 the simple messages of palliative care have not reached all parts of the healthcare system. Ellershaw and Ward's paper should be a wake up call to the deans of medical and nursing schools and to the royal colleges.1 No longer is it acceptable to teach surgery and medicine and not include palliative care in the curriculum. The wards of our hospitals are full not only of curably sick people who need care but also of dying people.
All trainees at every level should be able to demonstrate appropriate skills of palliative care in their exams and assessments. Perhaps if the General Medical Council were to drive forward this issue, particularly in training, it would restore some of its credibility and status.
Rabbi Julia Neuberger is wrong when she says that nothing can prepare a young doctor, nurse, or rabbi for facing people whose death is imminent. Training and education can prepare them, while practical experience develops their skills. I reflect on the painful memory of my first breaking of bad news, some 30 years ago. If I had had some basic training it would have been very different.
The goal of all of us should be to ensure that the current and the next generation of healthcare practitioners realise how fundamentally important care of the dying is, at the earliest point in their training.
References
- 1.Ellershaw J, Ward C. Care of the dying patient: the last few hours of life [with commentary by Rabbi Julia Neuberger] BMJ. 2002;325:30–34. . (4 January.) [Google Scholar]