Tell dying patients the truth
TERMINALLY ill patients must be told of their prognosis clearly so that they can make a decision on whether they wish to continue treatment or make end-of-life preparations and arrange for hospice care ("When treatment is futile"; Nov 24).
In our culture, relatives seem to prefer not telling the patient the truth.
The doctor, in trying to abide by the relatives' wishes, may inadvertently give the impression to the patient that a cure is possible, when palliative treatment is the only option.
This may lead to aggressive treatment that incurs a high cost, as well as side effects that end up making the treatment worse than the disease.
Doctors should also realise that patients in such situations are more emotionally vulnerable and would tend to accept any option presented to them that promises a cure.
They might cling to the possibility of getting better without understanding what the treatment entails in terms of costs, side effects and complications.
I once treated a patient with a terminal illness who, after consulting an oncologist, opted for conservative treatment. He shared with me how the specialist seemed to lose interest in talking to him after he had made his decision.
Several weeks later, his daughter informed me that he had died at home without much pain and said that he was rather comfortable in his last hours.
I agreed with her that her father had chosen the wiser option and in his case, the patient was the one who knew best.
Quek Koh Choon (Dr)