in the courts. Therefore, in more recent years it has not been so much the question: should the patient be told, but more the issue, how to tell. I am sure that we can all think of stories our patients and their families have told us, which not only express anger about being told, but more likely what the patient was told and how the information was imparted.
The study I told you about earlier, did not tell us that 100% of people wanted or needed all of the information. There is no indicator to guide us to the people who want information as opposed to those who don't, except that more affluent people are likely to want more information than those who are poor. So, how do we make sure that the people who want information get it, and those who don't are not upset by too much "truth"?
Before I go on to discuss the answer to this questions, it might be helpful to reflect on the palliative care setting I am used to working in. It is extremely unusual that the patient has not been told their diagnosis. It is also extremely unusual that the patient has not been told the reason for their referral to a palliative care service. The discussion health professionals usually have with patients and their families in a palliative care setting revolve around clarifying the extent of the person's illness and the most likely progress from this point onwards. Therefore, it is unlikely that some of the information given by the health professional, usually the doctor, is being told for the first time, but it may be the
Presentation for the Life Planning Centre in Tokyo, Japan, 23 February 1997,
