Tuesday, October 6, 2009

Spelling Out Thanatology.

Dr. Allen Malnak is three parts into a multi-part series on death, end of life issues, and bioethics considerations at NaplesNews. Here's part one; subsequents are linked at the bottom.

I could quibble with some of Malnak's points but for the most part the article is well-intentioned and informative:

I’d like to throw in the importance of physician-patient communication at this point. I have always felt physicians must be upfront and honest with their patients, even though it may be much more difficult both for the health care team as well as the patient’s loved ones. For many years a kind of “let’s keep any bad news away from the patient” mentality persisted among medical personnel. It didn’t work then, and it’s way out of line now. It’s the patient’s life, and every person is entitled to the best and most complete information the health care team can provide. Just because someone has developed a serious illness doesn’t mean that person has lost their ability to reason.

But we must keep in mind how the information is presented may well determine whether a patient continues to have a positive or negative attitude. In other words, even a life-threatening illness can be communicated as a challenge rather than a verdict. That’s the difference between hope and despair. Hope sustains us, despair overwhelms us. Hope and positivity are comforting, emotionally nourishing, and even healing, producing those “sense of well-being” endorphins. Despair wears us down even more, adding to our misery. So, no matter how grim the prognosis, a patient should understand that modern techniques of palliative and hospice care will almost always relieve the type of suffering that was common just a short time ago.

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