Your patient says “Nurse, Am I dying?” What will you do?
You are the Nurse looking after Mrs. Kyte who is dying. You have been told not to tell her that she is dying.
This is a hypothetical question which was posed to me by one of my Nursing Students. This is a very difficult situation and many nurses find themselves in these positions. I have been in this situation many a times. I hope my response will help some of you come to terms with similar situations.
Facts: In this situation, I have been informed that Mrs. Kyte does not know that she is dying. There are many variables in this situation. Yes, I have been told that the patient does not know that she is dying. It is my opinion that the person giving me the information honestly believed that the patient did not know she was dying. The truth may be different. So I will have to consider what is the truth according to the patient. I will assess the situation by asking the question, “What is happening, Ms. Kyte?”. This will allow Mrs. Kyte to tell me more about whatever she wants to tell me. It should answer the question of what she knows. She may tell me that Mr. Surgeon told her that she is dying or she may tell me that her faithful daughter told her that she was dying and that the family was behaving differently.
Analysis: Both these responses imply that the patient already know the truth. I will have no problem telling her the truth.
I have read the medical and nursing notes and confirmed that the patient is dying. I will have no difficulty telling my patient the trth.
The patient is asking me directly, ”Am I Dying?” I cannot and will not lie to any patient. This is a personal choice. It is a choice I have made deliberately and I have found it to be useful and morally right.
Another Assumption: The patient does not know that she is dying and I have been told not to tell her the truth. This request / order is illegal, wrong and misleading. It is like an order which tells you to commit a crime. An order which is illegal should not be carried and it is wrong to execute a crime.
The assumption in the question is that the patient does not know that she is dying. Lying to a patient will lead her to believe that she is not dying. She will not be able to organize her life’s closure. She may want to will her valuables to her dear ones, she may want to say her good bye to her loved ones.
There is only one situation where I may be persuaded to lie. This will be a situation where a patient has specifically requested not to be informed of impending death. Even this is hard to justify because we all have the right to change our minds and our wills.
In the final analysis, I will tell Mrs. Kyte the truth assuming that she is alert, conscious and orientated X 4 (person, place, time and situation) and is judged to be competent.
