Why do patients need to know they’re dying?

Old people are being stranded in hospital, diagnosed with terrible diseases but unable to recover enough to go home. Dr Adrian Boyle, the new president of the Royal College of Emergency Medicine, has said that NHS hospitals ‘are like lobster traps… easy to get into but hard to get out of’.

Might it not be better for some if they’d never gone, or at least never been told exactly what was wrong?

In C.P. Snow’s 1951 novel The Masters, the Master of a Cambridge college is ill. People seeing his bedroom light on night and day wonder how long he has left, but the question never occurs to him because he hasn’t been told he has terminal cancer and so believes he is recovering and will soon be back at the helm. Those Fellows who know the truth are appalled at the deceit but his family are adamant that he should remain in happy ignorance until the end.

This scenario, impossible now, was still usual in the 1970s, when my mother developed bowel cancer. She’d had diarrhoea for many weeks, and her weight dropped from eight to five stone, but it wasn’t until she was passing blood steadily that she consulted her GP, who sent her straight to an oncologist outpatient clinic. I drove her, in spite of protestations about the bus being perfectly satisfactory. The consultant was on an emergency so she saw his registrar and in the waiting room I could hear their conversation from a curtained cubicle.

‘You must come in for an operation. I’m getting you an urgent admission.’

‘What’s wrong with me, doctor?’

Today she would not have had to ask but even if the GP had stayed silent, the registrar would have replied: ‘You have advanced bowel and rectal cancer.’