"Truth at the bedside" and coping with it by incurably ill and dying patients

Abstract

Psychiatrists are increasingly consulted in the treatment of incurably ill and dying patients. They are not only confronted with the multiple anxieties and depressive syndromes of the patients, but they also have to deal with disturbances of the communication between doctors and patients and difficulties in the information of the patient about the diagnosis. Different attitudes of patients and doctors with regard to informing the patient relative to his previous knowledge will be pointed out. Arguments are presented for or against an open communication about the diagnosis. In addition, the risks of too much information as well as legal aspects of informing the patient are mentioned. "Truth" and "truthfulness" have a fundamental meaning in the doctor-patient relationship. The doctor's dealing with the various forms of anxiety and depression in incurably ill and dying patients is often accompanied by special difficulties. It is a prerequisite for the doctor to perceive and critically reflect his own emotional reactions in order to adequately accompany the patient to his death.