Care conversations must be appropriate

Advanced care planning – where doctors and patients have a considered discussion around how an individual’s care should be handled in the final phase oftheir lives – is an emotive issue.

Whenever the subject is broached it should be handled sensitively and with a person who is competent and fully understands the implications of their choices.

For the most part, conversations around end of life care and resuscitation orders are appropriate and respectful.

They can even serve to improve that vital bond of trust between individual patients and clinicians, removing anxieties that many vulnerable and medically high-risk people feel when contemplating their future.

But we are living in extraordinary times with coronavirus and it is clear that some conversations – likely a seldom few – have fallen below the the usual high standards.

Reacting to a Dundee case highlighted by The Courier this week, First Minister Nicola Sturgeon and Chief Medical Officer Dr Catherine Calderwood were clear that no-one should be pushed into making decisions they are not comfortable with. That position has not changed as a result of the coronavirus outbreak, nor should it.

Conversations around end of life care are absolutely vital in a patient-oriented healthcare system.

But, pandemic or not, they must be handled correctly and sensitively to ensure that, in their last moments, a patient’s wishes are respected and their dignity preserved.