The following is a post I made on a prostate cancer listserv known as the Prostate Problems Mailing List. I believe that the thoughts included in this post needed to be shared on a even wider basis. I made it in response to another members writing about his experiences with the death of his second wife and how much information he chose to give her about her impending death.

The issue of what to actually tell or not tell a person when they are dying is clearly a very individual and personal one. There isn’t a right or wrong answer, ultimately we each need to come to our own personal decision.

What I believe is best is that we need to communicate to our doctors and our caretakers what we want for ourselves. This needs to be done clearly, openly and in advance of the moment. We need to make sure they completely understand our wishes and agree to respect our wishes.

As we make our decision we should remember that not only will it effect ourselves, but it will also have direct implications on our families. Acknowledging the immediacy of our own death also means that our families too will need to accept our impending death. So, perhaps the decision making process on how much information that should be conveyed might also factor in their wishes and needs. Ultimately, however, the dying person’s needs and wishes should trump.

I have thought a lot about this and for myself and come to the conclusion that I want complete honesty. Personally, I want the opportunity to be able to complete anything I have left unfinished and most importantly, to tell my family and my friends how much I love them one last time. I also want the opportunity to leave behind a small additional legacy, to teach a final lesson to my children (maybe the most important one I can ever teach) about basic dignity of the human spirit.

Of course, no doctor is infallible and they do make mistakes. They can not and should not be specific in their predictions, the exact time of our death is ultimately not in human hands. But an experienced doctor can certainly tell that we have entered into the final stage, however long that stage turns out to be.

For some people being told that their death is to be expected soon could perhaps hasten it. It could remove the “hope” factor which does help some to live longer. Yes, the mind and what we are told does effect death. We often hear stories of shamans “hexing” someone who despite their being healthy then go off and die for no apparent reason. And how often do we hear about spouses who have lived together for many years and become so codependent that the death of one brings on the death of the other. Despite this, my person decision is to be told honestly.

We each, individually, need to decide what we want. Do we want to know the truth, or do we want to have that information “softened.” Again this is a very personal decision which will differ for each of us. We each need to make it very clear to our doctors and caretakers how much information and honesty we want.

Isn’t life an amazing journey.

Joel T Nowak MA, MSW