#Michael taply how to
In 146 numbered paragraphs, the guidance offers a framework for decision-making in considering commencement or withdrawal of treatment, and how to address the uncertainty about whether such interventions are likely to bring benefit, burden or risk to the patient. Decisions can be varied in the light of changes of fact and view as the situation evolves.
5 The language is excitingly concise yet comprehensible, with a glossary of terms and three clearly separated systems of references: to relevant publications, to web-based sources of information and guidance, and to legal precedents.Īll decisions must be recorded along with the discussion which has informed them. 3 It applies to the UK, identifying differences in legal requirements within the four constituent countries, and complements GMC guidance on good medical practice 4 and confidentiality. Reference Jolley and Tapley2 This new GMC guidance is written in the light of recent changes to legislation, including the Mental Capacity Act 2005, and legal challenges to some aspects of its predecessor. Psychiatrists, particularly those providing services for older people or working in liaison with general hospitals or hospices, need to be equipped to deal with death in prospect, in practice and in its aftermath. Under the cover, there is much that is welcome, helpful and important. Would a more arresting design in red and black, with dread symbols of death (gravestones, death certificates, wills, etc.) release the adrenaline to open the book? The doctors remembered receiving this guidance book, even its attractive cover, but not one of them had actually read it. In a straw poll of a score of doctors asked ‘What are your feelings when you consider end-of-life issues in your practice?’, single-word answers were the norm: ‘panic’, ‘terrifying’, ‘difficult’. Autumnal leaves resting on a greying background, their edges furled as if waiting to be wafted away on the slightest breeze, print in funereal lilac: the cover artwork of the General Medical Council (GMC) updated guidance on end-of-life care 1 points to the ephemeral and existential gentleness of nature in preference to the grim clichéd icons often associated with death and dying.