Dados do Resumo

Título

The conspiracy of silence in palliative care for cancer patients: A literature review.

Introdução

Patients who are facing an oncological disease with no prospects of cure and who are heading towards the end of life process, face repercussions directly related to the health professional's ability to tell the patient what is happening and also what will happen. However, there are often situations in which both the doctor and the family are aware of the progression of the disease, but some type of information censorship is achieved to avoid notifying the patient, a situation known as the conspiracy of silence.

Objetivo

Review the literature on the main aspects related to the lack of information for cancer patients during the terminal period of life.

Métodos

This is a literature review based on bibliographic survey, content evaluation and discussion among the authors. Primary information was used provided by the second edition of the book published by the USP School of Medicine "Manual de Residência de Cuidados Paliativos - Abordagem multidisciplinar" (Palliative Care Residency Manual - Multidisciplinary Approach) from 2022. In addition, were used as databases, the Scientific Electronic Library Online (Scielo) and Pubmed platforms, totaling 13 studies, based on the search for the terminology "conspiracy of silence" and "palliative care" connected by the Boolean operator "AND". Articles published in the last 10 years were selected, except for non pioneering articles addressing the issue. Among the studies selected, those that did not cover the theme addressed by the authors were excluded.

Resultados

In most cases, the conspiracy of silence arises from the false medical conception that not revealing the truth to the patient can help in the health-disease process, protecting them from possible pain. Furthermore, the gap in medical education that does not train healthcare professionals to deliver bad news to patients can result in the omission of information and the offering of false hope, which is also a cause for the conspiracy of silence. Likewise, the family itself may understand the omission of information about diagnosis and prognosis as an act of love. However, it has been proven that 87% of cancer patients want to know as much information as possible, whether favorable or not. Therefore, such attitudes tend to have the opposite effect, making the patient more anxious and with the feeling that they are being deceived, and as a consequence, it can worsen the doctor-patient relationship and cause family estrangement. Therefore, communication with palliative cancer patients must always address bad news, adapting information according to the emotions involved, respecting the family bond and evaluating the context before acting.

Conclusões

Finally, it is possible to conclude that the conspiracy of silence has a negative impact on cancer patients at the end of their lives, which is why health professionals should avoid the practice and intervene when identifying the phenomenon, so that there is honest communication between the health team, the patient and the family from the beginning of the relationship.

Palavras Chave

Palliative Care; Conspiracy of silence; Câncer