Sunday, July 16, 2017

Case regarding informing the patient or family first of any bad news...



You are discussing the care of an elderly woman with her family.Although she is awake and alert, the patient is very ill and physically fragile.You area waiting the results of a biopsy for what will likely be cancer which has already metastasized through out the body.The family asks that you inform them first about the results of the biopsy.They are very loving and caring and are constantly surrounding the Patient. They do not want to depress the patient further,and because there will be no hope for a cure they see no reason to ruin her remaining life with this information.

What should you tell them?
a. You will honor their wishes.
b. You agree with their wishes and you ask them to give you the necessary written request.
c. You ask them to involve the ethics committee for the hospital.
d. You tell them that you are obligated to inform the patient of all the findings.
e. Explain to them that that decision can only be made  y the health-care proxy.

Answer: d. You tell them that you are obligated to inform the patient of all the findings.

Discussion: Your first duty is to keep the patient fully informed about her health care.Unless there is significant evidence of possible psychological harm to a patient you have an absolute duty to the patient first and not the family.
One of the only examples of possible psychological harm to the patient would be of an actively suicidal person who may commit suicide if given bad news.

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