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Truth in the Relationship between Cancer Patient and Physician

Hardly a quarter of a century has elapsed since the time physicians were educated to tell compassionate and merciful lies to cancer patients. The words of Christoph Wilhelm Hufeland (1762-1836, a physician in Jena and Berlin) at the beginning of the 19th century, "to prophesy death is to cause it," have had lasting effect. It is remarkable that concealment of diagnosis and falsification of medical findings appeared suitable, especially in the case of cancer patients. Greater openness was practiced toward patients suffering from other illnesses with a comparable prognosis (myocardial infarct, cerebral insult, kidney and liver diseases). This must surely have something to do with the word "cancer," which has become a metaphor for agonizing pain, invalidity, and death.' In an age when illness, invalidity, and death had been banned from the daily life of society and delegated to institutions, it was inevitable that diagnosis of such a disease must have caused anxiety and terror. In a culture that refused to face illness and death, it was understandable that a patient was told merciful lies in order to protect him/her and to avoid anything that might worsen the course of disease. The attending physicians were only too happy to evade any involved conversation with the cancer patient, the patient's room was shunned, and the absence of the patient from his room during the physician's rounds was quite welcome.2