Another day, another story about death being a surprise to people. As part of a recent study, palliative care and radiology specialist doctors reviewed the records of their hospital’s most elderly patients, to count X-rays and scans performed in the last six months of life. They examined the case-notes of one in four of all the patients over the age of 80 who died in a six-month period of 2021. Between them, these 96 patients had 389 X-rays, 92 ultrasound scans, 192 CT scans and six MRI scans. The review found that burdensome tests – some of which have uncomfortable and even life-threatening side-effects– are being ordered and repeated even as the patients’ lives are drawing to an end. The authors speculate that ordering “more tests” diverts doctors and their patients from uncomfortable conversations about dying.
Although there may be better ways to spend limited NHS funds, it is not the financial cost of unhelpful medical tests that disturb me – rather it is the human cost to dying people and their families. After a long career in palliative care in an NHS hospital setting, I recognise the scenario this paper reveals: our reluctance to name, to recognise or to discuss dying.
