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November 22, 1965

The Necessary End

Author Affiliations

Drexel Hill, Pa

JAMA. 1965;194(8):935. doi:10.1001/jama.1965.03090210099040

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To the Editor:—  Dr. H. H. Neumann writes a letter, "To Tell the Truth." He objects to informing patients of impending death with no possible alternative or hope. I most sincerely agree. One can prevent a patient from seeking "quack" cures for incurable disease, see that he is legally and philosophically prepared for demise, but "leave the door open." There is almost always someone else to whom the diagnosis and prognosis can be explained.I disagree with advice to tell patients when they have cancer. I avoid this word. It implies complete hopelessness—as is physical life anyway. I always leave room for hope and encouragement while attempting to prepare the patient for death tomorrow if not today.

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