The patient with inoperable cancer from the psychiatric and social standpoints.A study of 101 cases

A team consisting of a psychiatrist, a social worker, a surgeon, and a surgeon studied a series of 100 patients as to psychiatric constitution, reaction, and social conditions during their terminal illness, bringing a solution to the problem of whether patients with incurable cancer should be informed fully of the diagnosis and prognosis.

Abstract

SOLUTION has been reached as to whether N patients with incurable cancer should be informed fully of the diagnosis and prognosis, or whether it is preferable to inform only the relatives of the situation, while the patient himself is kept in the dark or given the information only in answer to a direct question.On the one hand, we know by familiar experience that patients who are told that they have only a short while to live may become so depressed that they lose all pleasure in their remaining time.On the other hand, it would be favorable to the patient's management of his affairs, his confidence in his doctor, and his attitude to continued treatment if he were fully informed.T h e problem is of utmost importance, one that many practitioners have to face almost daily.Opinions remain widely divided according to the subjective approach of the individual.Many doctors prefer to withhold information from the patient, while in some quarters complete frankness is warmly advocated.No systematic investigation of a major series of patients, such as might furnish a firm objective foundation upon which to base action, has been made.T h e small series examined by means of questionnaires and the like cannot provide any solution to the problem.That being so, we formed a team consisting of a psychiatrist, a social worker, and a surgeon, and together we studied a series of 100 patients as to psychiatric constitution, reaction, and social conditions during their terminal illness.T h e study not only brought us closer to a solution of the problems mentioned previously but also afforded a comprehensive insight into the general situation of these patients.During the last few decades the task of psychiatry has been extended to embrace new fields in the care of the sick.Representatives of different somatic specialities have found the