Another day another clinical review. This one, led by the social work team, was mainly about issues in working with African people in a UK setting. As part of the discussion, though, an interesting exchange about the impact on families of people who don’t want to talk about their death.

Much of the discussion was about children, and the need to get a mother to acknowledge their impending death, so that they can work things out with their children and plan for the future. Although this is often an issue with African peoples, it also affects every ethnic group, and particularly younger patients. Nurses and social workers felt that this was an important issue to overcome for the sake of the children.

One colleague asked whether it was just as important for adults in the family. The view among nurses (no doctors present) was that their main priority was the patient, and whether adults, spouses and siblings for example, could talk with their patient about their position was that adult’s responsibility.

But social workers have, ethically, just as strong a responsibility for enabling family communication for everyone, including adults, and in general for the functioning of the family. As an advice worker pointed out, knowing that someone was dying is often crucial for securing the spouse or partner’s immigration status, and that, in turn, may well have an impact on children.

The point is a wider one, though. Should the assumption be, for a social worker and for other professionals, that another human being, just because they are an adult, is a lower priority for help than a child? You might think so when you compare the anxiety about deaths of children with the shrug of the shulders when it’s another old person who dies alone. What do you think?