tell him

　　Text/Peng Xiaohua

　　Issued in the 983th issue of China News Weekly on February 1, 2021

　　In a Chinese American family, the grandmother was suffering from cancer, and the family chose to hide it.

The heroine who grew up in the United States has always wanted to tell her grandma the truth. She believes that grandma has the right to understand her condition... This is the story of the movie "Don't Tell Her" directed by Chinese female director Wang Ziyi.

　　In reality, it was not until the last few days of his life that Mr. J learned that he was suffering from cancer. He also knew that as early as half a year ago, the first-visiting doctor had suspected the condition and told the family members who accompanied the doctor at that time and ordered an examination. .

　　Unfortunately, the family did not arrange for examination and active treatment, which objectively delayed the condition.

J has an unfinished business. He strongly hopes to survive and is willing to accept any treatment, but it is too late.

　　This is a more loser ending.

　　The deprivation of the right to know about major diseases often means the deprivation of the right to make treatment decisions, causing patients to lose the opportunity to make treatment decisions for themselves and get the treatment they want.

The experience similar to Mr. J is thought-provoking and distressing.

　　To this day, when a patient suffers from a terminal illness such as cancer, the common practice of doctors is still to tell the family members of the condition, and the treatment decision is often to ask the family members.

　　Of course, in most cases, treatment measures will still keep up.

But because they don’t know the imminent death, many people, like Mr. J, have not had time to complete or arrange the things that they care about most, or even have time to explain the funeral, or bid farewell to their relatives.

The motivation for concealing the condition may be good, and the actual harm to the patient objectively far exceeds the consequences they want to avoid by concealing the condition.

This injury is very serious, and the key is that it is irreparable.

　　The practice of concealing the condition is often based on the underestimation of the patient's ability to respond rationally and psychologically. They worry that the patient will fall into fear and despair after knowing the truth, aggravate the condition and accelerate death.

　　In fact, most patients have a good bearing capacity. Although they may experience initial shock and denial, they can quickly accept and face the facts and adopt a rational and pragmatic attitude.

　　There are also some patients who can guess their condition from various signs. They understand the good intentions of the doctor and family members, pretend not to know, and cooperate with the doctor and family members to perform.

As a result, when they needed each other's spiritual and emotional support the most, they kept their secrets and suffered lonely.

　　Western medical circles have also adopted the practice of concealing the true conditions of major diseases from patients. However, they realize that this practice does more harm than good, and because of the legislative protection of patients’ autonomy, the situation has fundamentally changed, and patients’ autonomy has been placed in four places. The first of the core ethical principles of big medical care.

　　Doctors need to adopt a sympathetic attitude, adopt a calm tone, and focus on the treatment plan. This will help patients increase their inner certainty-certainty is an important psychological support for patients with severe illness.

With the patient’s consent, involving family members in the conversation is also a desirable strategy to help them support and comfort each other.

　　Neither the partner nor the child is the patient himself. They have their own subjective standpoints, opinions, and even interests. The patient is the real bearer of what kind of treatment the patient is willing to receive, and what physical pain and spiritual price they pay.

Therefore, in the case of a clear-headed and decision-making ability, patients should enjoy the full right to know and decision-making power, which is in line with the principles of fairness and justice.

　　Other relatives of Mr. J have considered suing the court to accompany his family members.

　　In fact, the author believes that doctors and hospitals should be held accountable first because they have not fulfilled their duty of notification and professional responsibility. Only in this way can they really help promote the implementation of patients' autonomy, the right to know, and the right to make medical decisions.

　　I sincerely hope that doctors and their families will give patients the right to know about major diseases and medical decision-making power, and I sincerely hope that China will legislate to protect the rights of patients at an early date.

　　(The author is a translator of "The Best Farewell", a researcher of dying psychological culture)

　　China News Weekly, Issue 5, 2021

Statement: The publication of "China News Weekly" manuscript is authorized in writing