Cancer Discussions - September 3rd, 2009 - 8 Comments
If your elderly patient was diagnosed with cancer would you tell them?
Your a Professional working in a nursing facility with a frail elderly patient whom was just diagnosed with cancer and you have to abide to ethical regulations. When consulting with the family to determine what options they want to take, they request that all staff does not to tell the patient of the cancer. What would you do?
I agree the patient has the right to know in almost all circumstances. However there are exceptions. For example, do you know the patient hasn’t expressly stated he/she doesn’t want to know? Also, if one of the family members has healthcare power of attorney, it is basically a moot point- they have control over medical issues.
You should address this with your boss, and then perhaps with the family if your boss thinks that is a good idea. If the family is merely "protecting" the family member from bad news (and they have not stated that is the way they would like it beforehand) then this is an ethical dilemma. How would they know the patient might not want to visit some favorite last place or relative or friend if they knew they might die soon?
I see this almost daily. I have many family members pull me from the room and state they do not want their loved one to be told what they have. If they are demented or mentally unstable or if they can show me documents stating this is what they wanted, then fine. Otherwise I tell them I will state the diagnosis and furthermore generally whether it is curable or not, without going into explicit details (unless patient asks). If they don’t like this, I suggest they seek another medical oncologist.
Blessings
If you want to keep your job, then say nothing.
I think as long as people are in their right minds and can appreciate what is being told to them, they should know about their medical situation. I know I would pissed if my family kept something like that from me!
Legally, as long as the patient is mentally competent, they cant do that. But, legally, if the patient is incompetent and the family wanting this have the legal right to make decisions, its their decision.
Morally, I find it utmost incredably wrong to even suggest such a thing. Even for someone who may not be fully competent, they deserve to know the truth about their diagnosis. Chances are they know something is wrong anyways.
You have the choice to tell them still, but it could cost you your job, and maybe even your license.
I completely agree with midnight. It’s the patient’s right to know if they are competent. Who are you to decide what’s best for them?
does the patient have dementia or Alzheimer’s?? Is this a assisted living or nursing home? I believe the patient should know! and if the family is not the POA of this patient they really have no say so of it! Why wouldn’t the doctor tell the patient? Then again I see were the family is coming from to, I work in a alf an when our residents are told something like that they always seem to give up on life! But, If its bothering you that they are keeping it from the patient. I would have a talk with the family and just tell them how you feel about it and give and logical explanation of why you believe there family member should know about the cancer! Hope I helped you!
yea i agree with Midnight too you have too tell them or the family
Midnight is right. Legally in the US as well as in Canada if the patient is non compos mentis due physical or mental disease, physicians and healthcare workers are bound by the decision of the next of kin. Or the person who holds the power of attorney for personal decisions.
Morally though it is another story.
I would hate to be in your position, however the facility you work for is correct. It is not up to you or any of the other nurses to tell this patient of the cancer.