Post by mollybrazil on Jun 7, 2022 23:49:29 GMT
Discussion Question
You are a visiting health care provider in an Asian country. You are seeing a 74 year old male who presents with hoarseness, pain and mild dysphagia that has been slowly progressive over 4 months. You can see a large mass in the posterior pharynx and palpate enlarged nodes in the right neck. You suspect laryngeal cancer, likely squamous cell carcinoma. Chemo-radiation is not an option in this setting, but you feel that there is a good chance of cure with a total laryngectomy and selective neck dissection. Before you talk to the patient, his three daughters who flew in from Australis ask you not to tell their father that he has cancer, as it will make him depressed and he will give up.
What would you tell his daughters?
What would you tell the patient?
What things would you consider in making your decision on what to tell the patient and family?
Ideally before going to this country I would have a clearer understanding of cultural norms. If possible and if time permitting, I would ask colleagues about local customs related to health information in families. If this was not fruitful, I would approach the decision just as I would with a family here in the US. Assuming the patient has capacity, I would tell the daughters that ultimately it is the patient's decision whether or not he wants to know, but before telling him, I would ask him how much he wants to be told vs how much he wants his family to know.
You are a visiting health care provider in an Asian country. You are seeing a 74 year old male who presents with hoarseness, pain and mild dysphagia that has been slowly progressive over 4 months. You can see a large mass in the posterior pharynx and palpate enlarged nodes in the right neck. You suspect laryngeal cancer, likely squamous cell carcinoma. Chemo-radiation is not an option in this setting, but you feel that there is a good chance of cure with a total laryngectomy and selective neck dissection. Before you talk to the patient, his three daughters who flew in from Australis ask you not to tell their father that he has cancer, as it will make him depressed and he will give up.
What would you tell his daughters?
What would you tell the patient?
What things would you consider in making your decision on what to tell the patient and family?
Ideally before going to this country I would have a clearer understanding of cultural norms. If possible and if time permitting, I would ask colleagues about local customs related to health information in families. If this was not fruitful, I would approach the decision just as I would with a family here in the US. Assuming the patient has capacity, I would tell the daughters that ultimately it is the patient's decision whether or not he wants to know, but before telling him, I would ask him how much he wants to be told vs how much he wants his family to know.