Prognosis

The nature of the illness often does not change invasive treatments in terminally ill patients. Interventions may only end in disease-related and iatrogenic damages to patients with unnecessary over-treatment. The improper clinical practice is growing due to incorrect context, inadequate technical efficiency, and unnecessary usage of treatments that are not compatible with expectations and prognosis, and weak communication (Rising, 2015). In the Asian culture, there is often a belief that terminally ill patients should not be informed about their prognosis. I respect cultural practice. However, I think that patients do not need to be expressed that they are terminally ill. It does not, however, suggest we can pretend that we will relieve them of incurable illnesses or that we can withdraw from the predictions of those who desire them. However, maintaining that the “patient choice” over end-of-life care is a failed paradigm for therapeutic decision making, which causes more misery than mitigates it. For two key factors, the model of preference has proved useful. First of all, it is difficult to reveal a “terminal” prognosis since we have no specific description.

This inaccuracy is not just a semantic problem; it suggests that the medical profession and society typically fail to take account of the possibility of human mortality in the practice of medicine. The second issue for prognosis is the argument that patients need this information, particularly artificial life support, to make decisions about their care (Hordern, 2016). How such decisions are commonly presented reflects our uncertainty about the role of medication in the treatment of patients with life-limiting, terminal illnesses. The basic assumption is that patients can choose between life-long care and comfort-oriented therapy. Patients do not realize what terminally they are (whatever that means), nor what we should do with them, what it is going to be and what the course would be. We cannot heal largely metastatic lungs, so nobody can “choose” to die with them. Treatments will increase consistency and life volume but must end up working (Rising, 2015). While doctors cannot tell how long a single cancer patient survives, doctors recognize that these people worsen and experience further effects as the illness advances, ultimately needing assistance with everyday activities.

Pronounced functional decline is a prognostic marker for a portion of the disease progression, and is highly unlikely to benefit medication or artificial life support. Fully disclosing information to the patient is not an ethical breach. Patients claim they are forced to embrace mortality, to pursue suffering rather than recovery. Not unexpectedly, both the label and the choice are always refused (Hordern, 2016). However, the denial of the “terminally ill” label does not improve prognosis, confusing treatment direction, emotional distress in physicians, and fear and depression for patients and families. Patients with advanced illness and poor function do not realize how terminally sick they are to be allowed to ‘reject’ cardiopulmonary or chemotherapy regeneration. Such therapies will not, in most situations, be provided simply because they are terminally ill (Rising, 2015). While patients are entitled to the latest possible prognostic evidence, they have a right to ignore such knowledge.

References:

Hordern, J. (2016). Religion and culture. Medicine, 589-592.

Rising, M. L. (2015). Truth Telling as an Element of Culturally Competent Care at End of Life. Journal of Transcultural Nursing.