Article Text

Download PDFPDF
Comparing Kerala, India and Cambridge, the UK: a study of doctors’ and nurses’ attitudes towards palliative care
  1. Michelle Willmott1,
  2. Arjun Kingdon2 and
  3. Stephen Barclay3
  1. 1 Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
  2. 2 Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
  3. 3 Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Institute of Public Health, Cambridge, UK
  1. Correspondence to Dr Michelle Willmott, Hammersmith Hospital, Imperial College Healthcare NHS Trust, 150 Du-Cane Road, London W12 0HS, UK; mkswillmott{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Dear Editor,

We have recently undertaken a study comparing doctors’ and nurses’ attitudes towards palliative care in Kerala, India and Cambridge, UK.

The two countries have very different social and medical cultures, with differing health services and access to palliative care education that may influence clinicians’ attitudes towards end of life care. Palliative medicine is a young discipline in India: it was only approved as a postgraduate specialty in 2011 and there is no nationwide palliative care policy at present. By contrast, palliative medicine is a well-established specialty in the UK and a standard part of medical and nursing student training.

The study sought to compare the attitudes towards palliative care, prioritisation of resources and end-of-life decision-making among doctors and nurses in Kerala, India and Cambridge, UK, and explore the potential for further improvement in services in both localities.

A questionnaire using attitudinal statements and four-point Likert scales was developed from previous instruments,1 ,2 and administered to doctors and nurses working in specialist palliative care and generalist settings in India and the UK (Arthur Rank House Hospice and Addenbrooke's Hospital in the UK and the Institute of Palliative Medicine and Little Flower Hospital in India). Sampling was opportunistic. A translation for non-English speaking nurses from Kerala. Of the 99 respondents 48 were from the …

View Full Text


  • MW and AK contributed equally.

  • Contributors AK and MW planned the study, aided by SB's guidance. AK and MW jointly conducted the survey. AK and MW wrote drafts of the short report which were reviewed and improved by SB. AK submitted the study. Please note that the first two named authors (AK and MW) contributed equally to the paper and if possible would like to receive equal credit/‘joint’ first authorship.

  • Funding Royal Society for Asian Affairs.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All unpublished data is available to anyone who should ask, please contact the authors at or