Should paients be told they're dying by their doctors? Seems like a no-brainer, right?

Who wants to know that they're dying?  Most doctors will tell you that they often will not tell patients they are dying because patients don't want to know. Conventional wisdom is changing.

A new study by the American Society of Clinical Oncology reports that cancer doctors should be more candid about telling their patients that they are dying.  Patients should be told they are dying, according to the report, so they are fully informed of comfort care, i.e., hospice, or that their chemotherapy has become futile.

According to the study, fewer than 40 percent of advanced cancer patients have what it calls a "realistic conversation" with their doctor about what to expect and their choices of care.  The consequences are that patients are undergoing aggressive chemotherapy in the last two weeks of their life and their spending their last months hospitalized.  And they are not given the option of staying in hospice until their final days.  Hospice care at home can provide a dignified and personal approach to dying.

Patients must be informed about the terminal nature of their illness so they begin planning. Planning for death is not pleasant, but it's necessary.  Patients with terminal illnesses need living wills and a healthcare proxy so a person is clearly designated to make healthcare decisions for them if they are incapacitated.  The doctors and family members should be given copies of the living will and healthcare proxy, so there is no confusion when the patient is not mentally competent to make healthcare decisions.

A living will ensures that nurses and doctors will know what you want when you cannot communicate, such as whether you want resuscitative measures if you go into cardiac arrest.

Death is never pleasant, but the new approach recommended by this new study is a breath of fresh air for patients and their families who need to plan for the final days of life.