Should a doctor tell someone they have terminal cancer?

challengemaster

It's a bit of a ludicrous suggestion tbh. What would happen is doctor respects patients wishes, then the patient dies suddenly and nobody knows why. Autopsy reveals terminal illness, turns out the doctor knew and said nothing - family sues for malpractice. Repeat ad nauseam.

darkpagandeath wrote: »

And part of the Hippocratic oath.

Which no doctor in Ireland takes.

darkpagandeath

challengemaster wrote: »

It's a bit of a ludicrous suggestion tbh. What would happen is doctor respects patients wishes, then the patient dies suddenly and nobody knows why. Autopsy reveals terminal illness, turns out the doctor knew and said nothing - family sues for malpractice. Repeat ad nauseam.



Which no doctor in Ireland takes.

Link ?

Whosthis

darkpagandeath wrote: »

Link ?

http://www.google.ie

Conor Bourke

challengemaster wrote: »

It's a bit of a ludicrous suggestion tbh. What would happen is doctor respects patients wishes, then the patient dies suddenly and nobody knows why. Autopsy reveals terminal illness, turns out the doctor knew and said nothing - family sues for malpractice. Repeat ad nauseam

If the doctor has informed the patient that they're terminally ill and the patient chooses not to be informed about their prognosis and/or declines treatment, the doctor can't force them to do anything and a post mortem wouldn't take place because the patients medical records would show that they had an incurable illness. It's not the doctors fault if the patient doesn't tell their family they're sick, there would be no legal case whatsoever.

The family could only sue the doctor i, after the patients death it came to light that the doctor discovered that the patient had a terminal illness but the patient was never informed at all or given any choices.

darkpagandeath

Whosthis wrote: »

http://www.google.ie

Is it not up to the person stating facts to back them up google does not count.

Fleawuss

Loop Zoop wrote: »

Lol, I defer to your extensive medical knowledge and experience. You clearly know exactly what you're talking about :rolleyes:

ETA: I fundamentally agree with you regarding the part in bold, it's just obvious that you haven't a clue about the realities of what constitutes communication between doctors/nurses and patients/families or the importance of therapeutic relationships in end of life care.

You sound like someone who did a course. I've repeatedly pointed to you that the first responsibility and duty of a doctor is to their patient. Your attempts to insinuate a role for some interfering idiot of a loved one into that is bizarre and nonsensical. Any doctor breaching their duty to the patient to defer to the notions of a loved one not to tell than should be reported to the medical council. As already said to you.

Whosthis

darkpagandeath wrote: »

Is it not up to the person stating facts to back them up google does not count.

Link?

darkpagandeath

Whosthis wrote: »

Link?

To what ??? How online debates work ?

Baby Jesus was actually called Kevin you now have to take that as fact...

Zimmey

Yes, the patient needs to know. In case there is anything they want to do and to make sure they say all their goodbyes. And to allow them to get their affairs in order. If they don't know it''s terminal, some of this will not be achieved.

keeponhurling

In my head, this is how the conversation goes

Doctor: "We've decided you don't need to continue with the chemo treatment anymore, or make any more visits to the hospital.
Just staying at home should be grand"

Patient: "I see, so does that mean the treatment worked ? I'm cured?"

Doc:"Eh...yeah, sure"

Patient:"Great! So how soon you think I'll be ok to go back to work?"

Doc:"Eh, probably best not to rush back, really"

Patient:"Ok well thanks for all your help, Doctor. So this is goodbye, I'll probably not see you again until my annual checkup next year"

Doc:"Eh, yeah sure. By the way, I've written you a prescription for a 6 month supply of morphine. Eh, as a precaution,not that you'll need it of course, but just in case of, eh, heartburn or something"

Patient:"Thanks doc, I knew you were the right man to help me beat this disease.
Next time I bump into you down the town, the drinks are on me"

Doc:"Thanks. But sure lets keep it low-key, no need to go signing my praises from the rooftops, just doing my job"

Patient skips out of the office to give the news to his family and friends, possibly announcing it on Facebook

Conor Bourke

Fleawuss wrote: »

You sound like someone who did a course. I've repeatedly pointed to you that the first responsibility and duty of a doctor is to their patient. Your attempts to insinuate a role for some interfering idiot of a loved one into that is bizarre and nonsensical. Any doctor breaching their duty to the patient to defer to the notions of a loved one not to tell than should be reported to the medical council. As already said to you.

And I've told you that I unequivocally agree with your fundamental argument that the patient comes first. I've never said that a doctor would or should breach their primary duty of care to the patient to appease a family member. You're just being obtuse by insisting that doctors have no obligation to develop any form of therapeutic relationship with the patient or their family.

Whosthis

darkpagandeath wrote: »

To what ??? How online debates work ?

Baby Jesus was actually called Kevin you no have to take that as fact...

Are you that lazy that you need to be spoon fed facts?

Is google too difficult for you?

You don't have to accept anything that anyone posts but posting "Link?" certainly doesn't disprove anything. Its just an asinine response used by idiots that are devoid of anything useful to contribute.

kylith

IMO the only scenario where it could be acceptable not to tell someone that they're terminally ill is if they are not mentally competant to deal with that, i.e., a small child or an elderly person with dementia.

challengemaster

darkpagandeath wrote: »

Link ?

http://www.imt.ie/opinion/guests/2009/04/what-does-the-hippocratic-oath-mean.html

Loop Zoop wrote: »

If the doctor has informed the patient that they're terminally ill and the patient chooses not to be informed about their prognosis and/or declines treatment, the doctor can't force them to do anything and a post mortem wouldn't take place because the patients medical records would show that they had an incurable illness. It's not the doctors fault if the patient doesn't tell their family they're sick, there would be no legal case whatsoever.

The family could only sue the doctor i, after the patients death it came to light that the doctor discovered that the patient had a terminal illness but the patient was never informed at all or given any choices.

Maybe I picked it up wrong, but the OP and thread title both suggest that the patient should NOT be told they have a terminal illness at all. Not just to not give them a timeframe.

corner of hells

keeponhurling wrote: »

In my head, this is how the conversation goes

Doctor: "We've decided you don't need to continue with the chemo treatment anymore, or make any more visits to the hospital.
Just staying at home should be grand"

Patient: "I see, so does that mean the treatment worked ? I'm cured?"

Doc:"Eh...yeah, sure"

Patient:"Great! So how soon you think I'll be ok to go back to work?"

Doc:"Eh, probably best not to rush back, really"

Patient:"Ok well thanks for all your help, Doctor. So this is goodbye, I'll probably not see you again until my annual checkup next year"

Doc:"Eh, yeah sure. By the way, I've written you a prescription for a 6 month supply of morphine. Eh, as a precaution,not that you'll need it of course, but just in case of, eh, heartburn or something"

Patient:"Thanks doc, I knew you were the right man to help me beat this disease.
Next time I bump into you down the town, the drinks are on me"

Doc:"Thanks. But sure lets keep it low-key, no need to go signing my praises from the rooftops, just doing my job"

Patient skips out of the office to give the news to his family and friends, possibly announcing it on Facebook

Insensitive .

Rubberlegs

I really think it depends on the patient and whether they want to know or not themselves. At times I think someone knows their time is up anyway, and doesn't necessarily need to be told. I'm convinced by things my Dad started to say, even before he was diagnosed, that somehow he knew he didn't have a lot of time left. No one outright told him that he didn't have long, Though I remember the consultant telling him he'd almost died after a particularly gruelling bout of radiotherapy. I found that no one outright told us he didn't have long. Personally, I wouldn't have believed it at the time, wouldn't have been able to listen. I can remember him being upset one day, he insisted he'd overheard doctors talking about him, saying his prognosis was not good. When we queried this we were told no way that would have been said within his earshot. He didn't ask, and we didn't ask, but we all knew deep down that this was it. I don't know what difference it would have made to him had he been told, to be honest he had started to slowly withdraw from the world anyway. I think I'd rather not know for myself , though I would like to think I would be told up straight if I did want to know.

Anita Blow

It's not really an option- the patient has to be told. The patient's ability to give valid consent is contingent on them being able to make an informed decision about their care so they must be informed about their diagnosis/prognosis. Their care will be transferred to a Palliative team and there is no dancing around that.

Azalea

It's a requirement I'd have thought. Especially when there was a doctor in Cork a couple of years ago who was found guilty of professional misconduct for failing to disclose a patient's probability of cancer to him (the patient subsequently died). Appears to have been an error by the GP and I feel sorry for him but the case goes to show how there clearly is no other option. Why would there be?

ToddyDoody

I feel a doctor should give a sound diagnosis and prognosis in all instances.

Things they shouldn't do are call a patient a cnut, for instance.

qo2cj1dsne8y4k

When my dad was diagnosed he was told without treatment he would die, but was not given a "time frame", when I spoke to my GP, my GP obviously knew it was terminal and was talking to me about it and said that we could ask the oncologist for a time frame, if we wanted to, that that was something he could tell us but to be honest, the oncologist didn't come at us with the "you have 6 months" or he didn't ask if we wanted to know.
So, I think sometimes they do wait to be asked.

ted1

You need to know so that you can get in with your bucket list and sort out your affairs.
I have three kids that need to be looked after. I'd need to set them up