2012 EDUCATIONAL BOOK - American Society of Clinical Oncology

DOCTOR’S DUTY TO PROVIDE
The value of studying hope in oncology and palliative care
is to understand the role it plays in psychologic health, in
making decisions about treatment, and in establishing goals
of care. 20
Talking about death and hope from the day of diagnosis
means that when the disease has run its course, the discussion
will be the continuation of a conversation, not a spinechilling
revelation. The responsibility for presenting medical
information in a way that enables the patient to balance
acceptance against hope lies with the treating oncologist.
Author’s Disclosures of Potential Conflicts of Interest
Author
Simon Wein*
*No relevant relationships to disclose.
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However, the oncologist is not obligated to prescribe hope
and the oncologist can do better than collude or be disingenuous
to reinforce hope.
There are other values in life—family, work, hobbies,
dignity, achievements—that the oncologist can explore a
little at each visit. Discussion about these values may (or
may not) enable acceptance of death. However, as Breitbart
noted, “The paradox of the end of life dynamic is that
through acceptance of the life one has lived comes acceptance
of death.” 21
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