How to inform patients at the end of life?

Publié le : 7 May 2013
Should we tell everything to a patient at the end of life? The right to know is a fundamental right of patients. However, the opinions of professionals diverge on the way to inform them in situations that are quite often the source of anxiety. The British Medical Journal put the question to L. J. Blackhall of Virginia University in the United States, and to Emily Collis of Saint Charles’s Hospital, London, and Katherine E. Sleeman of King’s College London.         
The American doctor writes that it is not necessary to tell patients if they are or are not in the terminal phase, particularly since there is no consensus among doctors on what palliative care should be given in the "terminal phase". Patients do not want to know if they are in the terminal phase but what medicine can or cannot do for them. And that is what should be explained to them.
In contrast, the London doctors write that informing patients about the seriousness of their illness is primordial, because "it is key to a series of important decisions" such as assigning power of attorney, the choice of guardians, etc.
In the United Kingdom, the General Medical Council, the equivalent of the Order of Doctors in France, has stated that patients ought to be informed about their prognosis, but that the way of presenting "the truth" is essential and must be done in a respectful manner and while providing support. It puts the emphasis on the fact that only conscious patients can decide to receive or refuse information, and that the deliberate attempt to hide the truth from the patient may create anxiety and complicate the grieving process of the family.

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