ABSTRACT
There is a contrast between curative medicine where the body is viewed as an engine which needs mending and the care to enhance the life of the engine, seeing that it is a treasure. Medical intervention, whether by surgery or pharmacology, direct care or talking treatments make for a change in a patient’s life or their view of it. Physicians need to be mindful of the fact that situations of patients are complex and that things have to be considered properly and not only technically as in “We have the possibility to do these things and we do it”.
Evidence-based practice has far reaching consequences on the way doctors think, and on their responsibility as a professional. Trained to answer questions and exercise control, some are uncomfortable with a change in appreciation of their authority. The doctor-patient relationship is further threatened by an increasing liability culture.
It is a good thing that physicians and people in general are aware that life has to end sometime and that quality of life is something worth working for. It is a never-ending challenge to look for what is important for this individual patient at this moment in time. Every patient history has to start with listening.
