is in no way a script for the situations in which you as individuals practice the art and science of palliative care. I invite you to reflect on this presentation and take from it whatever is relevant to your own situation. I sincerely hope that some of it will be useful.
The truth and terminal illness in the Western Culture
In a recently published survey 96% of people had a need to know that they had cancer, and 79% of people wanted as much information as possible. In the same sample 91% wanted to know the chance of cure and 94% wanted to know the side effects of treatment.
More affluent people wanted more information than those who lived in deprived areas. There was a strong preference that the diagnosis was given by a hospital doctor (60%).
These findings are not surprising, we live in an information age, and people expect the information they need to make the best possible decisions about all aspects of their lives. Health care is no different. However, this needs to be balanced against a death denying society in which beauty, glamour, vitality and youth are very much revered. Also, the reality of death touches people less frequently throughout their lifespan, than it might have fifty years ago, before the advent of modern medical management The high expectations we have of the capacity of modern medicine is also regularly fuelled by the media.
The law, especially law relating to consent in America and Canada has further increased the imperative to make sure patients have enough information to make informed decisions. This has been less influential in England and Australia, but nonetheless is regularly tested
Presentation for the Life Planning Centre in Tokyo, Japan, 23 February 1997,
