The right to know or the right to live?

Should the doctor tells the patient everything? And if the prognosis of the disease is extremely unfavorable? The results of scientific studies and the opinion of the psychotherapist.

The right to know or the right to live?

Honesty in a relationship with a client - one of the basic principles on which built Western civilization in general and medical practice in particular. This principle is based on the moral paradigms lie immoral person has the right to be informed about everything that relates to it. In addition, honest communication takes precedence over false and from a pragmatic point of view: a man must think of the situation in its true light and in its entirety in order to decide how to behave in order to make a personal choice, which he certainly has the right to .

But there are cases that put this principle into question. If a person was in a situation that when viewed from the side it seems hopeless, and he perceives it as such, he dropped his hands and develop a sense of helplessness. As a result, it is usually not able to take any effort to try to change something. But the so-called objective assessment of the situation usually does not take into account the potential of its dynamics - which may well occur when a creative approach to solving problems and in general with the active behavior of the individual, which happened in this situation.

Introduction of the patient with a fatal prognosis - it does not protect his human rights, and the doctor's defense against charges of concealing the truth

This is particularly relevant to human health. Health preservation and restoration in the course of treatment depends largely on the potential of the body's immune functions, and they, in turn, is largely determined by the active search of human behavior. * A recent international study on cancer patients **, which were considered uncollectible and, according to medical prognosis would soon die. But they survived, and even cured of illness. The researchers found that common to all survivors were active behavior: active participation in the treatment process (search the Internet information about the disease and new approaches to treatment, search for qualified doctors, etc...), Active participation in social life, including helping others people. Many of these patients are aware of the hopeless prognosis, but this information provoked a feeling of helplessness caused them to protest and became an incentive to resist.

Much more often people after such a forecast passively awaiting the end - and do die. Message of doom disarms the human face of his illness. This message can be fatal even in the case of medical error -.. That is, if a person does not actually have cancer! And if patients were determined to doctors and psychologists to fight and would, for example, are familiar with the results of the above study, the number of survivors might very increase. But to do that doctors should abandon the idea that the patient as an independent person, should be fully aware of the prognosis of the disease. Full information about it does not own one, because of the disease depends not only on the performance at the moment, but also on the vital position of the patient. And even if a person still dies of the disease, active life in his remaining time is filled with meaning and hope. Familiarize the patient with a fatal prognosis - it does not protect his human rights, and the doctor's defense against charges of concealing the truth. This setting should be changed at the level of the whole society. The right to life above the right to this knowledge, which can be life-threatening.

* Details: VS Rotenberg, Vladimir Arshavskii. "Search activity and adaptation" 1984.

** M. Frenkel et al, in Support Care Cancer, 19:. 1125-1132, 2011