This is generally the best policy. The best doctors are able to inform the patient gradually and with humanity, always avoiding expressions that might be interpreted as a “death sentence”; in medicine, we can never be completely sure and it cannot be taken for granted that what happens in most cases will also happen in the individual case in question.
There are three general considerations that support the policy of informing the patient:
- Patients are quick to realize when things are not going well. An air of mystery will only increase their anxiety. If adequate explanations are not given, the patient may well begin to believe that nothing more can be done, even when there is a very good chance of achieving a cure.
- Family members hugely underestimate the patient’s capacity for intuition, and so they naïvely believe that she does not suspect anything. In this way, the frustration of loneliness is added to the patient’s fear of the unknown.
- A very sick person changes; often, she will display a strength that was unsuspected before she became ill. She goes into battle against the cancer, while the healthy members of her family can only watch this struggle from outside, without understanding the profound change that is taking place in her. We can therefore understand why certain results of therapy, which seem so modest to a healthy person, are so important to the patient. Without adequate information and dialogue, it is difficult to take the best decisions for the patient in difficult situations.
Of course, there will always be patients who are not obsessed by technical questions; they are satisfied with the “interior narrative” that they have constructed for themselves and do not wish to be “bothered” with lots of medical explanations. However, people like that are very rare. WHY IS THE PATIENT SOMETIMES NOT ADEQUATELY INFORMED?