When it comes to doctor patient collusion, most of the problems appear when dealing with a

terminal illness such as non-treatable cancer.

There are two options for the doctor: full disclosure of the illness and prognostic of survival
or semi-disclosure.

To understand better these choices and their worst outcomes here are two examples:

1. Patient A presents to the hospital for a hiatal hernia. The doctor checks the patient's history
chart and finds that he was diagnosed with an adenocarcinoma of the esophagus. Then the
doctor asks the patient if he is undergoing any treatment only to find out that the patient didn't
even know he had cancer.

In this case, if there would have been full disclosure, the patient could have had access to
treatment at an early stage of his disease and therefore a better prognostic of survival.

2. Patient B is diagnosed with 4th stage colorectal cancer. The doctor tells the patient that
there is no cure for the illness and at this point he can only get a palliative treatment to help
him ease the pain. Four hours later the patient commits suicide by jumping off the balcony at
the hospital.

Our opinion is that there should be a full disclosure in the doctor-patient relationship but
things should be taken step by step in order to avoid the worst case scenario. This means that
the doctor must assess the patient's psychological status first by requesting a psychiatric
consult. It that is not possible, the doctor should at least be able to consult with a psychiatrist
regarding the patient's status.

As a doctor we should be able to anticipate patient’s reaction to cancer. It depends on his age-
Cancer diagnosis has a greater impact on young people -, his social status –it is crucial to
make sure they understand their condition. It is said that we should avoid word „cancer” and
use terms such as neoplasm . But in some cases as Pacient A, they might not understand . We
try so much not to hurt them and we kill them instead.

Withholding information from the pacient is ethically uacceptable.As long as he is capable of

making an informed decision , we should sensitively and respectfully inform them about their
condition. We should always express our commitment of support , never destroy their hope ,
answer their quetions and also family presence can help to ameliorate the pain and accept his
condition easier.