Peter Jones

Doctors and death

issue 27 October 2018

The Royal College of Physicians has suggested that doctors should learn to talk to patients about death. But talk about what, precisely? The medical diagnosis? Matters spiritual? Philosophical?

In a play about his fate, Prometheus, the mythical champion of mankind, said that he had benefited mortals by preventing them from foreseeing their death. Asked how, he replied ‘I lodged blind hopes in them’. This reflected a school of medical thought which took the view that offering the patient encouragement could prevent them ‘giving up on themselves’ and actually keep them alive.

Not everyone took that approach. In a world where anyone could become a doctor (we hear of 18-year-olds starting to practise), it was vital to maintain one’s reputation. So doctors were advised to steer clear of treating the dying. Those observing the ‘scientific’ teachings of Hippocrates (5th century bc) simply confined themselves to ‘rational’ assessments of whether a patient would improve or survive.

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