Collusion in doctor-patient communication

doi:10.1136/bmj.322.7293.1062/a

BMJ 2001;322:1062 ( 28 April )

Letters

Collusion in doctor-patient communication

Patients rarely regret optimism

Specialist palliative care staff could act as treatment brokers

Knowing is not always best

Doctors should adopt patient's perspective

Patients rarely regret optimism

The first 150 words of the full text of this article appear below.

EDITOR $---$ Imminent death is not the inevitable consequence of a diagnosis of small cell lung cancer, as The et al say in theirpaper.¹ They are wrong in saying that life expectancy is amaximum of two years. A recent analysis of patients on the NationalCancer Institute's database showed a five year survival of 12.2%in patients with limited stage disease.² Remission and prolongedsurvival can be achieved only by active treatment with chemotherapyand radiation, and yet The et al report that patients familiarwith the plight of incurable cancer refused treatment. This willcertainly have compromised the survival of those patients, andyet it seems that The et al are advocating that all patients shouldbe similarly persuaded of the hopelessness of theirsituation.

It remains true, however, that most patients will die of their disease within two years, but we believe that the false optimism. . . [Full text of this article]

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Collusion in doctor-patient communication about imminent death: an ethnographic study: Anne-Mei The, Tony Hak, Gerard Koëter, and Gerrit van der Wal
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