We debated how much, when and even if a patient should be told about their condition, irrespective of the condition, and whether it was ethically acceptable to tell the relatives of the patient before the patient themselves. Views exchanged by the Algerian doctors in the class included comments such as:
- Patients are only told what is hapening to them depending on their educational level, some patients don't need to know
- It depends on the situation as I wouldn't tell a person with cardiac failure that he could suffer from sudden death at any time as it would be too stressful for him
- People in the Western world are independent and need to look after themselves so it is different for them, but Algerians are cared for by their families and therefore their families may be told things that the patient is not
- Doctors in Algeria haven't had the training to talk to patients honestly about end stage disease
- There isn't the support for the patient in the community once they have been told
- We wouldn't talk to a patient about their prognosis as they may live longer or less time than we have told them
- What about a patient who has a secret wish to do something before they die such as go to Mecca or get their affairs in order? Surely they have a right to know their prognosis as early as possible so they can fulfill their dreams before they are too sick to do so?
- When families are told about someone's condition, it is usually the males in the family who are told as it can be too emotional for the women.
This discussion opened my eyes to a new perspective, one which I look forward to discovering more about.
If you would like to send comments on the discussion above or anything else, please send them to me. I will post them on the blog unless you tell me that you wish them not to be.
I look forward to hearing from you!
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