Social work and end-of-life care

Social work is important in end-of-life care

In end of life care, good life and good death is the aim, not ‘saving’ people

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130131 Reduction in life caseI have come across a law report on an end-of-life care issue that concerns many people: the doctor misdiagnosed a skin cancer, and was sued for a breach in her duty of care. This was the nature of the case (quoted from the judgement):

It is common ground that if the Defendant had referred the Claimant to a specialist with a suspected malignant melanoma in March 2006, as she should have done, he would have been seen within two weeks and the tumour would have been excised. The Claimant’s case as originally put in the Particulars of Claim was that “excision and treatment at this time would have carried a likelihood of cure and survival”. A fallback case, not spelt out until Professor James wrote a supplementary report very shortly before the trial, is that excision and treatment in March 2006 would at least have given the Claimant a longer period of disease-free survival.

My interest in this case is that the fallback case succeeded, not the original case. The successful case claimed for loss of a longer period of disease-free survival rather than a likelihood of cure. I often complain about press reports that people were ‘saved’ from death by medical interventions, or statistics are quoted saying that so many thousand people would be ‘saved’ from death if this or the other service improvement were made.

The point is that people are never saved from death, because we all die; what may happen is that their death is delayed and they have, as in this case, the potential for a ‘longer period of disease-free survival’. The concern in end-of-life care is about how long we can help people to have a good life before a good death. It is not about ‘saving’ people.

Link to the law report.


Written by Malcolm Payne

1 February 2013 at 11:07 am

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