Psycho-oncology and the terminally ill patient

Abstract

This paper discusses difficulties faced by the terminally ill cancer patient and the case for psychological help. The hospice movement that started 40 years ago has made great strides in assisting people achieve the so-called "good" death. Communication between patients, clinicians and family members is still cause for concern. Issues such as denial, discussing bad news and distancing strategies by health professionals are reviewed. The dying patient is described and illustrated by a case example, together with how delirium and pain can be managed. Finally, some recent evidence, about increasing acceptance of physician-assisted suicide, is discussed.