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Tue 11 Sep 2007 04:00 AM

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Doctors fail on ‘ABC’ of patient dignity

Clinicians are failing to provide dignity-conserving care, claims a leading palliative care expert writing in the British Medical Journal (BMJ).

Clinicians are failing to provide dignity-conserving care, claims a leading palliative care expert writing in the British Medical Journal (BMJ).

Doctors too often dismiss dignity in care because of a lack of time or expertise, writes Dr Harvey Max Chochinov, one of Canada's leading palliative care experts and professor at the Department of Psychiatry, University of Manitoba. Chochinoov has outlined recommendations to promote empathy among clinicians, termed the A, B, C, and D of dignity-conserving care.

This guide has its origins in palliative care, but can be applied across all medicine, says the author. Based on empirical evidence, the guide explains how kindness, humanity and respect are core values of medicine, but which are often thought of as the "niceties of care" only offered to patients if time and circumstances allow.

The importance of the four parts of the guide - A for attitude, B for behaviour, C for compassion and D for dialogue - is underlined, says the report, by the fact that loss of dignity is one of most common reasons patients seek out physician-hastened death.

Perhaps changing attitudes needs to pervade all medical school teaching, add Irene Higginson and Sue Hall, a palliative care doctor and psychologist at King's College London in an accompanying editorial. They suggest that; "Chochinov's ABCD should be the first mnemonic we teach all professionals entering health and social care."

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