Patients have right ‘not to know’ about death
Dr Joan McCarthy, lecturer at UCC’s School of Nursing and Midwifery, said one of the downsides of the focus on patient autonomy is a “compulsion to tell” on the behalf of medical professionals.
“Patients have a right not to know and that needs to be respected. Some patients feel emotionally unprepared to hear bad news. Some patients feel that it is a very private affair their dying and they don’t want to talk about it with professionals.”
Dr McCarthy said Irish doctors often use euphemisms in a bid to see “where the patient is at” in relation to their illness. This “pulling hen’s teeth” way of relaying information can sometimes be appropriate with terminal illness patients and their families. Again it is all about the needs of a particular individual with other patients preferring clarity and directness of approach.
Dr McCarthy cited the experience of writer Nuala O Faoláin who was diagnosed with metastic cancer in a New York hospital in a far from sensitive manner having presented to an emergency room with pains in her legs.
Dr McCarthy said Ms O Faoláin’s experience highlighted what are the positives of the often hesitant approach of Irish doctors who use euphemisms such as “You are going downhill” when dealing with people with terminal illnesses.
She said surveys carried out by the Irish Hospice Foundation (IHF) and others indicated a very low level of awareness in Ireland in relation to decision making involving end of life care. Dr McCarthy said members of the public are not always aware of medical terminology such as CPR (Cardiopulmonary resuscitation) or DNR (Do Not Resuscitate).
A survey in 2007 found that 92% of patients would prefer to be informed if their condition is terminal. 57% would prefer to hear the news from their doctor on their own while 35% said they would like to have family with them.
