Callous doctors?

[cornflakecrunchie]

Why do they tell (especially older people) nowadays that they're going to die? Would you want to know? I certainly wouldn't. I can't understand why they aren't 'treated' with some placebo.. the power of the human mind would otherwise see them off faster, or maybe that's what's wanted these days?
The (two) people that I know of are just sitting at home now, wondering if the next symptom means The End.

Describing doctors as 'callous' is out of order too!

My late dad was told there was nothing else they can do - it devastated him, and us. I agree with you OP - medics should speak to family members and make a plan based on what is best for a particular patient. why? Because it was the truth?

As for dr’s should speak to family to decide, how infantilising. My family don’t speak for me, and if I found out that they’d colluded with the dr’s to withhold information about my health and prognosis from me I would never speak to them again.

Just because someone is terminally ill/has a bad prognosis doesn’t mean we automatically assume on their behalf that they lack the capacity or emotional resilience to be told the truth.

Amazing how people seem to think that a 16 year old can have a termination without her parents’ knowledge because it’s her body and her choice, well, a terminally ill person has the right to know their prognosis, because… their body their choice.

I would rather know than be kept in the dark m especially if its a terminal illness, at least it would give me time to sort things out.

You can’t disclose information to patients families without their express documented consent and without telling the patient first.

So if you don’t tell the patient the family won’t know either.

I’d rather know.
firstly to get my affairs in order and secondly to make sure all my loved ones know what they meant to me.
I got a call that my 59 year old Father had died unexpectedly, I’ve never really got over it
I know he loved me and he knew I loved him but it still hurts.

OP I don’t know what you’re talking about it, it makes no sense. You know this is 2024 don’t you, not 1824. If someone is of sound mind and has a capacity, the default is always to tell them all their medical information. They can choose to share it with others if they wish. But gone are the days when people were told that their wife/mother/father/grandad/grandma had cancer and were going to die, while the patient was kept in the dark. Any doctor who kept medical information a secret from the patient, and told others family members, would get into a lot of trouble.

”callous doctors” - give me strength !!!

Its a cultural thing. In the UK they are brutally honest about life expectancy in the face of illness. But often not entirely accurate. My mum was told in August 2017 that she'd live through Christmas but probably not the next one (2018). She died in Dec. 2020. So its a rough estimate. My uncle was told he had 6 months, he lived for 18 months.

I would much prefer these kind of benchmarks, to get affairs in order and do what needs to be done.

I'm living in the US where doctors are very truth avoidant.

People have a right to know the reality of their situation. Having that knowledge means people can make their own, informed decisions about their affairs, how they want to live the time they have, and how they want to die when the time comes.

Doctors aren't being callous or cruel when they tell someone medical information; they're respecting the person's legal and ethical rights to have the information.

@cornflakecrunchie I'm sorry you and your loved ones are going through this. If you haven't already, you might find it helpful to contact a relevant charity for your loved ones' conditions, as they often have practical and emotional support options available. Your loved ones could also consider liaising with their specialist team or GP about an Anticipatory Care Plan (names of these can vary), so they and healthcare professionals have a guide for what they want to happen under various circumstances (eg if they become unwell in different scenarios, would they prefer to stay at home or go to hospital, how invasive/aggressive would they want treatment options to get, how can things like pain or anxiety be managed effectively, what are their priorities for dignity and comfort?).

Why do they tell (especially older people) nowadays that they're going to die?

A better question might be "Why has our society evolved to the point that we are in total denial about death and dying particularly with regards to the elderly?"

The notion that it's preferable to extend life by any means possible even if it means barely existing and subjecting someone to endless medical interventions is a fairly modern phenomenon. My grandparents fully accepted that old age meant that any day could be their last and didn't have an overwhelming fear of death.

Life is finite. Doctors are obligated to be honest about that. As other posters have said - not everyone has a fear of dying.

Do some research into this please. It isn’t being callous - doctors have a legal duty to be candid, transparent and open about your information. It is simply not okay to not disclose information and they would be rightly sanctioned for it. It is useful for people to think about how they want to live their lives, to make choices about how much medical treatment they want etc.

I wouldn't like to know, but I feel like I would need to know so I could prepare DH and the DC for my demise. How horrible for them not to know I am seriously ill and suddenly I am dead? Or worse, the doctor tells them so they know, but can't tell me.

I'd be terrified but would rationalize it. 'The doctor says I have X months to live, this means most people with this condition live for X months so I may live longer, or I may live less' and then I'd just hope.

We are all just one road accident, stroke, or severe heart attack away from death anyway when you get to my age.

@Scirocco Thank you for the information about Anticipatory Care Plans, this might already be on the agenda, I'm not related to the patients, but will pass it on. Thanks again.

@Mirabai Where you there? At this point, my sister was unable to walk unaided or indeed, eat without being fed... what nice thing do you think she might have wanted to do? She asked me to sit with her and to talk, so that is what we did, after all she had been my big sister for 60 years at that point and apart from our last surviving aunt, I was the person who had known her the longest. Also, I was helping to provide end of life care at home.

Frankly, I am not seeking your forgiveness but I do suggest that you might like to do something that we do in the healthcare profession and take a little time to reflect upon what you write.

I can remember when they told my husband his cancer was inoperable. Of course that wasn't the news he wanted to hear, but we both appreciated the honesty. I would have hated being stuck in the older system where the family were told and the patient wasn't. I couldn't have spent the last months of his life lying to him, nor would he have wnated me to.

I want to know, and I'm old enough to know exactly what that means. It's medical information about the patient and it is theirs by right.

But maybe there were things she would have wanted to do differently, things she might want to say. You can't possibly know. I understand it was done with compassion, but it wasn't your information to withold. I'm surrpised, frankly, that you knew and she didn't. That's not the way doctors operate these days. Was it a long time ago?

@LatteLady I'm so sorry people are having a go at you. You did nothing wrong in my opinion except love & care for your sister.
I'm sure she'd already 'got her affairs in order' as posters are so keen on mentioning!

I lost my best friend a year ago next week. She was 42 and knew she was going to die young for some years. She wanted to know, wanted to have her life in order, wanted to give her parents specific instructions for the end. If you've never been in this situation, you don't know whether you'd want to know or not, and even if you think you do know, it's fine if someone else has the opposite wish.

Thank you, yes she did. We are an Irish family so talking about death and getting things in order was second nature but our conversation was several days before she died and planning for Christmas was a real pleasure for her, so I do not regret the conversation at all.

It doesn’t matter how disabled she is. In the previous post you claimed the prep for Christmas was her favourite time of year, now you’re saying she couldn’t walk or eat unaided in which case the time of year is neither here nor there.

It’s concerning that you claim to work in a healthcare profession and yet lied your own sister about her own life and death. If anyone needs to take to reflect it’s you I’m afraid. Thankfully medical ethics would prevent you from taking such a wrongheaded approach with patients, in whatever capacity you do or do not work with them.

Agreed. Possibly well-intentioned, but controlling and unethical.

@L@LatteLady Your decision to not tell your sister aside, I am interested to know how you came by this information about her scans etc.

You said you saw the growth of the tumour, you saw that it had grown from the beginning of the week to the end of the week.

I sincerely hope you didn’t abuse your position as a healthcare professional to access this information. Because no doctor would give it to you, so how did you come by it?

My sister knew her diagnosis was terminal, she was told six months with treatment and weeks without, so it was her decision to stop treatment and come home. She planned her funeral about a year earlier when she was well and had bought a funeral plan and then so did her husband, she told me that she thought he would go first and had already selected readings and hymns. We had conversations when she decided to come home and in the early hours. It was six years ago, but now I celebrate Christmas for her and follow old family traditions handed down by my mum and Annette and raise a glass to them both on Christmas Day.

My dad died of bowel cancer in 1981. It was recommended that we not tell him he had cancer and so despite two stoma surgeries and drug therapies he was supposed to believe that it was ‘ulcers’ or something vaguely similar. It was hugely stressful all round to keep up the pretence and l have absolutely no doubt he knew perfectly well what he had. I also have no doubt that he would have welcome the opportunity with which honesty would have presented him, to discuss openly the turmoil he must have kept to himself to the end.

Placebo is so unethical. If anything, we need to talk more openly about illness, death and dying ( society as a whole). Advanced care planning ( including DNAR) should be a standard discussion for more people than it currently is.

I think I would want to know if I had a terminal disease.
However I am not sure I'd want to be given a predicted timeframe or be told if my death was pretty close. That would just make me more anxious and distressed.

Twice in my life, I've had procedures done where the doctor pretty casually said to me 'oh, you might die.' shortly before I was about to have it. That was an awful experience but fortunately I am still here and it wasn't the case that my last moments were spent worrying like that!