Truth may hurt but deceit hurts more: communication in palliative care

Fallowfield, LJ; Jenkins, VA; Beveridge, HA
July 2002
Palliative Medicine;Jul2002, Vol. 16 Issue 4, p297
Academic Journal
Healthcare professionals often censor their information giving to patients in an attempt to protect them from potentially hurtful, sad or bad news. There is a commonly expressed belief that what people do not know does not harm them. Analysis of doctor and nurse/patient interactions reveals that this well-intentioned but misguided assumption about human behaviour is present at all stages of cancer care. Less than honest disclosure is seen from the moment that a patient reports symptoms, to the confirmation of diagnosis, during discussions about the therapeutic benefits of treatment, at relapse and terminal illness. This desire to shield patients from the reality of their situation usually creates even greater difficulties for patients, their relatives and friends and other members of the healthcare team. Although the motivation behind economy with the truth is often well meant, a conspiracy of silence usually results in a heightened state of fear, anxiety and confusion - not one of calm and equanimity. Ambiguous or deliberately misleading information may afford short-term benefits while things continue to go well, but denies individuals and their families opportunities to reorganize and adapt their lives towards the attainment of more achievable goals, realistic hopes and aspirations. In this paper, some examples and consequences of accidental, deliberate, if well-meaning, attempts to disguise the truth from patients, taken verbatim from interviews, are given, together with cases of unintentional deception or misunderstandings created by the use of ambiguous language. We also provide evidence from research studies showing that although truth hurts, deceit may well hurt more. 'I think the best physician is the one who has the providence to tell to the patients according to his knowledge the present situation, what has happened before, and what is going to happen in the future' (Hippocrates).


Related Articles

  • Use of a pro forma and overhead projector to improve multi-disciplinary team communication. Oliver, David; Haggarty, Pat // International Journal of Palliative Nursing;Aug2003, Vol. 9 Issue 8, p358 

    Focuses on the use of a pro forma and overhead projector to improve multidisciplinary team communication in palliative care. Assessment of the usefulness of the overhead projector pro forma; Effectiveness of the pro forma in encouraging interdisciplinary working.

  • Producing user-friendly patient information: part 2. Gamlin, Richard // International Journal of Palliative Nursing;May2002, Vol. 8 Issue 5, p256 

    Part II. Reviews web sites that provide palliative care practitioners help in developing patient information for patients and their families. The Plain English Campaign; Hospice Information.

  • Facts and fallacies in palliative care. KHOO, Siew Beng // Asia Pacific Family Medicine;Sep2003, Vol. 2, p143 

    The concept of palliative care is still quite new in Malaysia. Through the experience of delivering palliative care in both the hospital and community settings, the author has realized that there are many false beliefs among the medical and nursing professionals, as well as patients and their...

  • Care, Not Cure: What to Say When Treatment Fails. Sawyers, Mary // Approach: The Naval Safety Center's Aviation Magazine;July-Sep2002, Vol. 47 Issue 7, p133 

    Discusses the proper skill needed by oncologists and other cancer clinicians to communicate with patients at the transition to palliative care. Behaviors involved with relating to patients; Review of the results of treatment; Coordination with patients to revise the goals of care; Healthcare...

  • Teaching physicians how to talk.  // Hem/Onc Today;5/10/2011, Vol. 12 Issue 9, p1 

    The article reports on the release by the American Society of Clinical Oncology (ASCO) of a policy statement encouraging physicians to talk to their patients about palliative and end-of-life care options that are available for patients with advanced disease.

  • Attitudes and beliefs of palliative care physicians regarding communication with terminally ill cancer patients. Bruera, E.; Neumann, C.M.; Mazzocato, C.; Stiefel, F.; Sala, R. // Palliative Medicine;Jul2000, Vol. 14 Issue 4, p287 

    The subject of communication between palliative care physicians and their patients regarding their diagnosis and prognosis has not been extensively researched. The purpose of this survey was to compare the attitudes and beliefs of palliative care specialists regarding communication with the...

  • Manualized Communication Interventions to Enhance Palliative Care Research and Training: Rigorous, Testable Approaches. Weiner, Joseph S.; Arnold, Robert M.; Curtis, J. Randall; Back, Anthony L.; Rounsaville, Bruce; Tulsky, James A. // Journal of Palliative Medicine;Apr2006, Vol. 9 Issue 2, p371 

    Palliative care practice requires excellent communication between the patient, family, and clinical team. Experts in the field have proposed a variety of communication interventions that can be used in the palliative care setting. However, these interventions are at a high level of generality:...

  • Breaking bad news: starting palliative care. Doyle, Derek; O'Connell, Sean // Journal of the Royal Society of Medicine;Oct1996, Vol. 89 Issue 10, p590 

    The article offers advice on how to properly communicate bad news to patients. One of a doctor's most distressing tasks is telling a patient that he or she has a lethal illness. The author suggests ways to gently break bad news to patients. After breaking the bad news, the next decision is about...

  • Good Communication: The Essence and Reward of Palliative Medicine. Liao, Solomon; Arnold, Robert M. // Journal of Palliative Medicine;Aug2007, Vol. 10 Issue 4, p956 

    The article focuses on communication issues between health professionals and patients and their families. Palliative medicine physicians are increasingly being viewed as the communication specialists. It is important therefore, to ensure that palliative care physicians are trained adequately to...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics