Should the patients be sick, should the family members conceal it kindly, or do they tell each other truthfully?

Today, I talk about the problem of ethics. The patient is ill, especially the relatively heavy illness. As a family member, should it be concealed or truthful?

Believe that this issue, as a family member, everyone will have the answer that they think of "correct", and there will be a solution that they think very well. Indeed, since it is an ethical issue, it is difficult to use "right and wrong". This relatively simple and rude one -the -the -the -xicator is explained, and it seems that the answer to this question itself is only "reasonable" and no "right or wrong."

As the author himself, honestly, from my student days, I have faced this choice from the time of my student, to later internships and participating in work. Unexpectedly, of course, it also includes this situation.

What should I do? The family's words, my choice is to tell the truth. Or I admire this straightforward "straightforward" method. Because I think that if such a serious illness, especially the major diseases that are not very good, such as cardiovascular disease, nervous system disease, tumor, etc. I have a full understanding of my current situation, and do a good job of psychological construction and feasibility planning for my future situation.

I believe that when many readers see this, they will feel that the author is too rational to do things, too much understanding, and almost harsh requirements. Let's take a few examples.

Case 1, a few years ago, a patient experienced by the author was a doctor because of the breast and massage, and the puncture results of the outer hospital reminded breast cancer. When he was soliciting the opinions of the family members of the patient, the family members were "concealed". The basic policy of one day, install a smile in front of the patient every day.

Until the three days before the operation, when my family members asked me how I should explain to the patient again, I proposed an objections and suggested telling the patient's actual results and the content of surgical needed.

There are a few reasons:

1. Copy medical records after the patient is discharged, and you can clearly read the tumor diagnosis written by the surgeon and the patient's related pathological reports. The blow may be larger than before surgery.

2. Moisturizing and cure surgery of breast cancer is different from the utensil tumor root treatment surgery in the breast and abdomen. Cut the edge directly suture. After the patient wakes up after anesthesia, even if you touch it, you can realize the asymmetry on both sides of the chest, and naturally you can't hide the results.

Family members obeyed my suggestions and explained the current disease problems with the patients. The patient quickly spent the psychological "denial period" and "anger period" and directly entered the "acceptance period". The surgery and postoperative cooperation are very positive, and the current consultation is also good.

Case 2, the patient had coronary heart disease at the age of 50. After being introduced by a friend, I found me and visited the Department of Internal Medicine of our hospital.

The results of the pre -operative examination reminded that the coronary heart disease of the old K is still very heavy. When a colleague of the cardiac colleague talked to his family, he also clearly explained that if the coronary heart disease intervention (commonly known stent surgery) cannot meet the treatment of the disease treatment, It may need to be transferred to the "coronary arterial bypass transplantation" (that is, the generally said bridge surgery).

The family members automatically ignored the possibility of surgery explained by colleagues in the Department of Internal Medicine in the great thought of "people to win the sky" and signed the word in a hurry. Before the operation, family members did not communicate with the old K. Reading results: The old K coronary condition is not suitable for interventional stent surgery. If active treatment, you can only choose bridge surgery.

When the cardiac doctor told the family members, the family members immediately collapsed and cried into a ball, because whether it was subjective or objective or objective to block the content of this conversation. Essence Old K was unable to accept the treatment of his disease and chose to sign and discharge.

Case 3: It is also a case of an acquaintance. The young male was found "thyroid nodules" during the medical examination. However, the family members prefer the patients and concealed the content of this "follow -up". They took the patients to go through the Beijing -Tianjin -Hebei region, hoping to meet a doctor to help them solve the way to cure without the clinic. As a result, after a year of visits, the thyroid nodules still did not go there, but the patient had caused emotional depression due to excessive mental stress. Later, the mental psychology department completed the next step.

Therefore, in the author's opinion, life, sickness, death, and people are common. The illness is part of human growth. Since it is an adult, it should have the basic quality of their own independence and have the courage and confidence to overcome the disease. The concealment of goodwill, although as a family member, is expressed in terms of nouns such as the so -called "filial piety" and "love", but it may really be out of consequences and desires. Replacement, so don't hide it, tell the truth, the sooner the ideas are better.

May all readers and family members happy Corning!

Author: Wang Jianxu, anesthesiology center of Beijing Anzhen Hospital

[Reminder] Pay attention, there are a large number of professional medical sciences here to reveal those things about surgical anesthesia ~

- END -