by W. Diane Van Zwol

Created on: October 23, 2009

What Should Doctors Tell Terminally Ill Patients?

"Am I dying?"

What doctors tell patients about terminal illnesses, is usually determined by the medical doctors' level of judgment, in conjunction with their professional discretion and the patient's health status.

When the family of a patient advises a doctor, that a patient must not alerted to the reality of his or her terminal illness, the doctor is then in an ethically challenging position. Where should the doctor's loyalty lie, i.e. with the patient or with the patient's family? His moral, ethical and legal status, could be at stake.

Truth, honesty and integrity are extremely important in the care, compassion and concern that doctors have and demonstrate with regard to dying patients. This is also true with respect to the relationship between dying patients and their families.

"Don't put me in that kind of position!" a doctor might suggest to a family member, who asks him or her not to tell a terminally ill patient the truth about his or her illness.

Patients do have the right to know that they are dying.

There are often important personal issues or concerns that dying patients need to deal with, when death is pending. For example, there may be power of attorney papers or wills that must be signed, estate settlements that need to be made, financial arrangements to be taken care of with regard to dependents or personal property, business details to be dealt with, etc.

Who will become the dying patient's beneficiary? Who is going to handle the patient's personal affairs, after he or she passes away? The patient should be involved in the decision making process, whenever possible, as this part of a patient's responsibility for himself or herself, as well as where other family members, friends or business associates are concerned.

Honoring a patient's request, regarding the truth about disclosure of his or her terminal illness, is part of a doctor's moral, ethical and legal responsibility. At the same time, when the family becomes involved, there is a larger picture and family members must be included in the decision-making process, as well. Sometimes a lawyer's participation is necessary.

There may be serious concerns about the mental status of the patient, as well as his or her health. In this kind of a situation, the doctor and family may have to make the decision about whether the patient should know that he or she is terminally ill. Is the patient able to understand the reality of his or

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