Palliative Medicine: communication to promote life near the end of life
In many ways, end-of-life care is planning for the worst and hoping for the best. Patients seem to know only too well they are getting more ill, not responding to treatment and that their life is rapidly drawing to a close. But it also seems that, unless the doctor has courage and compassion to listen openly and allow the unspoken questions to be voiced, the patient will comply with the conspiracy of silence. In different healthcare systems, the organisation of funding determines how palliative care services link into the oncology services. Without information about their own condition, however, cancer patients cannot make choices on how they want to live in the last phase of their lives. This chapter discusses the role of communication in dealing with cancer patients who are in delirium, the Mental Capacity Act 2007 in the United Kingdom, discussion of death with a cancer patient, communicating about medications and palliation, and dealing with hope and hopelessness in the patient.
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