16 JUNE 1967, Page 26

Sentence of death

LETTERS

From A. Anis, Desmond Stewart, David Car- rington, John Hunter, R. L. Leonard, Barrie Heads, Vera Houghton, E. D. O'Brien, Paul Smith, Dennis Scuse. T. W. Blyth, Jill Mortimer.

Sir: Leslie Adrian may be right about teaching hospitals. The incompetence of provincial hos- pitals is far worse. My stepfather is presently dying from a secondary and primary cancer. His care and treatment as an Nils patient could not conceivably have been worse. 'In removing the growth we have damaged the waterworks, so there will have to be another operation'—information given by an unconcerned young doctor.

In writing about fatal diseases ('terminal cases' is the medical term), hospital procedures are im- portant. It is usual to carry out pathological tests upon removed growths in the case of cancer to discover (I) whether it is malignant and (2) the degree of virulence.

The results of these tests are then reported to surgeons, who inform or do not inform the patient or the patient's family. Having in advance been told by a grinning nurse, 'When they take a long time we know it's bad,' I was prepared for the result

Neither the nursing staff nor the surgeon intend to inform my stepfather that he will die within the next three months. This lowers and removes any remaining shred of human dignity. It also contravenes the contract of employment. Doctors are engaged to: (I) discover and report back on illnesses; (2) recommend treatment, if any, to the patient. They are not engaged to make decisions about the patient without consulting him.

Even worse, the above-mentioned grinning nurse justified this by saying," 'It's not as if he was a private patient—then things would be different.' We all pay a large amount of money in both direct and indirect taxation to employ medical and nursing staff and to support hospitals—my step- father, as a surtax-payer, more than most. It seems not possible to convince the employees that hospitals exist for the benefit of the users and not for the convenience of the staff. While private practice is allowed to continue there will inevitably be two classes of care, for the staff get paid to provide superior treatment The staff money- grubbing and the near-deification of medical workers are the causes. Emergency—Ward 10 has

much to, answer for. The Patients' Association has much to attack. It could add these ideas to its list.

London WC I Name and address supplied