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Hello, my name is Robin Taylor and I am
a consultant respiratory physician working
in NHS Lanarkshire and NHS Lothian in Scotland.
It's a privilege to be sharing with you some ideas
concerning the topic of medical decision-making in acute care.
This talk is going to be delivered in two parts:
part 1 is to do with philosophy and the approach to the issue, and
part 2 will deal with the more topical issue of treatment escalation planning.
I'd like to take you back to just a few years ago, when Her Majesty the Queen paid
a visit to the display of ceramic poppies surrounding the Tower of London.
That was to commemorate the 100th anniversary of the onset of the First World War.
That war resulted in something like 20 million deaths, of which
nearly a million were British and Commonwealth servicemen.
This is the picture that commemorates their sacrifice.
What happened in the aftermath of the First World War was
a reaction, not just to mass mortality, but to mass bereavement.
We became a culture that was essentially what I'm going to describe as 'death-denying'.
The death-denying culture is one in which the approach of death in
critical illness becomes almost a taboo topic,
and that's a taboo that affects you, me, the patients and their families whom
we're encountering in day-to-day practice.
It's important for us to remember that that has an impact on medical decision-making.