Throughout the year IAHPC board members contribute a range of opinion pieces and other thought-provoking articles to the IAHPC Newsletter. Now it’s the turn of Dr. Derek Doyle whose immense contribution to the field of hospice and palliative medicine has been recognized throughout the world.
What a ridiculous question! It takes some of us back to the pioneering days of the late 20th century. True, ‘quotable quotes’ come flooding back. For example, the doctor who claimed:
“None of my patients has ever come back and complained of my care!” (At least he believed in life after death!).
“You’ll not get me prescribing morphine even if they have pain – I’m too aware of the adverse effects of opioids: addiction and depression of respiration.”
“You’ll be expecting me to pray with my patients next!” “ Have you any idea how busy I am – far too busy to be listening to old pensioners unburden themselves – isn’t that what a priest is for?”
All true quotes... some of the hundreds of responses to our pleading that ‘hospice care’ (as it was called before ‘palliative care’) be given a chance; be seen as no less, no more, than good clinical care. Faster than many of us expected hospice/palliative care gained believers, followers. Soon, general practitioners (GPs) in their hundreds were enrolling in courses, hospital palliative care teams were inspiring and supporting junior doctors, student nurses were relishing study days at their local hospice/palliative care centre. One thing they would all have agreed was that hospice/palliative care was an undeniable right of all with far-advanced illness – a necessity and never a luxury!
Here in the UK, we are still proud of our National Health Service but we are going through difficult times. Though we all knew people were living longer, our politicians and planners failed to provide sufficient hospital beds for them or care homes for those no longer able to be cared for at home. The result is that hospital beds are ‘blocked’ with people who need day-to-day care but there are insufficient care homes. Nor did they see that general practice was attracting fewer recruits than needed to fill vacancies and that practitioners were both over-stretched and demoralized, even though most do no evening, night or weekend work. Most consultations are limited to 10 minutes whilst notices in waiting rooms remind patients that only one complaint can be dealt with in 10 minutes. Home visits are many fewer than a few years ago. Our saddest time has been in recent months when junior doctors went on 24-hour strike; so over-worked and under-valued did they feel.
All doom and gloom? No – far from it. Record numbers of GPs and nurses (both hospital and community) are enrolling in palliative care courses. Even more interesting and significant is that many see such courses as a means of improving their communication and team-working skills – both essential in whatever specialty they work. It brings back memories to some of us of proclaiming with all the energy and authority we could muster “Palliative care is not, nor ever will be, an exercise in clinical pharmacology.”
Is this a crisis time? Not if we all remember that palliative care and its principles are essential for dignified and compassionate living as well as dying! If palliative care becomes a luxury, or is even thought of as a luxury, we have failed.
Dr. Derek Doyle is recognized for his outstanding contribution to the development of palliative care in Scotland, the rest of the UK and throughout the world. He was founding President of the Association of Palliative Medicine of Great Britain and Ireland and the first consultant specialist in Palliative Medicine in Scotland. He established and was senior editor of the Oxford Textbook of Palliative Medicine and was the first Vice Chairman of the European Association for Palliative Care and first Chair of the European Committee for medical education and training in palliative care.
We are honored that Derek is also a founding and lifetime member of the IAHPC – read his bio here on the IAHPC website.
You can read more personal reflections from Dr. Doyle on the University of Glasgow End of Life Care Studies blog.
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