Collusion in Doctor-Patient Communication about Imminent Death: an Ethnographic Study

Collusion in Doctor-Patient Communication about Imminent Death: an Ethnographic Study

Hak, Tony, Gerard Koëter, and Gerrit van der Wal British Medical Journal 321, no. 7273 (2000): 1376-1381
https://doi.org/10.1136/bmj.321.7273.1376

“Almost all patients with cancer want to know their diagnosis and most patients also want to be informed about the chance that they will be cured. This does not imply that these patients want to hear the really bad news about their condition. Many patients, when they fear that their prognosis is rather poor, do not ask for precise information and do not hear it if it is provided by the doctor. Our study started from the observation that after their first course of chemotherapy virtually all patients with small cell lung cancer in a university hospital programme showed a “false optimism” about their recovery, in the sense that the patients’ interpretations of their prognosis were considerably more optimistic than those of their
doctors. It was not unusual for a patient to tell relatives and friends that the doctor had informed them that they were cured, when actually the cancer was not cured and the life expectancy of these patients was a maximum of two years.”

— Tony Hak et al.