ABSTRACT
Psychiatry and palliative medicine attend patients who are mentally distressed and dying. Neither condition is easily amenable to biomedical interventions. In palliative medicine it is a ‘good death’. The diseases of neither patient group are curable. The best that can be achieved is symptom control and maintenance of that control. The claiming of palliative medicine by physicians’ colleges, and the narrow base of specialist medicine training, has resulted in very limited exposure to psychiatry by prospective palliative medicine specialists. Palliative care nurses usually possess considerable experience and intuitive skill in dealing with disturbed patients, but lack a sound psychiatric knowledge base. The practice of clinical psychiatry and medicine in general, requires knowledge of psychology. Modern psychology is cognitive and behavioural in philosophy. Psychodynamic conceptualisation is less emphasised. There is a considerable literature concerning psychology and severe illness. The psychiatric literature is less robust. The discipline of psychiatry encompasses both organic and psychological dysfunction.
