eLetters

400 e-Letters

  • Lost in Clinical Translation: Difficult communication in futility
    Joseph Y Ting

    Getting your message across to a patient and their family is difficult and fraught with misunderstanding. Aside from not having enough time and patience to explain complex diagnoses and sophisticated treatment plans as well as ensuring that understanding has occurred, English may not be the patient's first language.

    As a hospital doctor, even when using non-technical terms, I wonder whether a family member or a p...

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  • Patients with psychosis should not be disqualified from assisted dying on grounds of mental incompetence.
    Kevin R. Smith

    Dear Editor.

    Schuklenk and van der Vathorst's feature paper articulates powerful and persuasive arguments to the effect that denying patients with treatment-resistant depression (TRD) assistance in dying results in unnecessary suffering and amounts to unfair discrimination against TRD patients.

    Beyond TRD, the same arguments can readily (and in my view appropriately) be used to support assisted dying...

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  • It's Not Just About 'Quality of Life'
    Joseph Ting

    TO THE EDITOR: Unexpected critical illness and the possibility of death for which loved ones and relatives are unprepared leads to upheaval and is destabilizing. In time-constrained settings where patients and their families have not had end-of-life discussions about the use of aggressive treatments, doctors face difficulties with overwhelmed and unprepared patients and families. For these distressed families, it is dif...

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  • Should Obesity Be a 'Disease'? -Heavy and healthy: the latest take on obesity
    Joseph Ting

    It remains controversial whether overweight and obesity confer protection when one becomes afflicted with a chronic disease. The debate would benefit from a shift in focus from susceptibility to more serious iterations of a whole range of chronic medical problems, to the obese sustaining higher acute risks from anaesthetic, pregnancy and post operative complications. They are more difficult to resuscitate in trauma and...

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  • The pendulum could swing the other way: underperforming doctors are left alone
    Joseph Ting

    To the Editor: Harassment and bullying are unacceptable in any workplace, let alone the health professions whose calling purportedly subscribe to healing, compassion and humanity. The highly publicised examples of sexism and exploitation serves notice to perpetrators fuelled by the perverse incentive of hierachical authority gradients. It goes without saying that we need a paradigm shift in standing up to the inertial s...

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  • More than the bi- and tri- of parenthood, paid parental leave, same sex parents and gay marriage are ethical considerations that matter to society at large
    Joseph Ting

    More than the bi- and tri- of parenthood, the equity and justice of paid parental leave, same sex parents and gay marriage are ethical and pragmatic considerations that matter to society at large.

    The press rightly highlight the workplace obstacles that women face in sustaining a career and raising their children. However, we neglect to mention that the childless in society already subsidize and assist with the...

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  • Secrecy can confer unequal power, confidentiality should confer respect
    susanne stevens

    Respect for citizens' rights to confidentiality have come a long way over the past decade or so in the UK but not without resistance in some parts of the medical establishment. Along with and allied to confidentiality, respect for a person's right to know what is being said about them (access to files) has been something of a struggle and still is for those who are incarcerated in prisons or hospitals. 'Secrecy' rather...

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  • Depression is not the only treatment-resistant psychiatric condition.
    Colin Brewer

    Dear Editor. I do occasional psychiatric assessments for people contemplating medically-assisted rational suicide (MARS) in Switzerland and broadly agree with Schuklenk and van der Vathorst's arguments. Usually, my role is limited to assessing mental capacity and excluding the existence of a treatable psychiatric condition that might be influencing the patient's decision to include MARS in the list of acceptable options....

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  • PLR - better to boost PPI
    Malcolm Harrison

    The Article states "In health research, funding bodies and academic institutions actively undertake patient and public involvement programmes to ensure that studies adequately reflect the perspectives and input of patients and citizens." I do not agree.

    I have been a member of a research ethics committeee in England for seven years. I do not recognise this statement, nor would my colleagues. In very few cases...

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  • Where should this go next?
    Peter H Brooks

    I think this is a very important article. Well written, well researched and timely.

    It seems that there is a large body of ancient wisdom locked away in the Adab writings. I suspect that there will be material of great value to Western, as well as Islamic medical practice.

    I had, until now, been only vaguely of Adab, as a counter-balancing ethic, to Sharia. I'm ashamed of my ignorance, and also surprise...

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