A question about medical ethics:
We have an 81-year-old patient with a fairly aggressive cancer. She came in yesterday, her son immediately asks to speak to us in the hall. The family is worried she wouldn't deal well knowing she has cancer, and her primary doctor agreed not to tell her and to instead call it an "infection" when talking to her. Giving her appropriate treatment, but hiding the actual diagnosis from her.
The patient has no signs of dementia, seems mentally competent.
The attending agreed to do what the son was asking. So now we're all calling this thing an "infection" and telling her the chemotherapy drugs are "antibiotics".
I find this appalling.
Her son doesn't have medical power of attorney over his mother. I don't know how we can say that she's giving her consent to treatment when she's being lied to about what she's being treated for. I don't know what the son plans to do if the mother finds out what she has, and finds out we've all been in cahoots with her son to lie to her. I don't know what anyone expects we're supposed to do if the "antibiotics" don't work, and she needs some sort of surgical intervention, or more powerful treatment, or how you talk to someone about advance directives when they aren't aware of the gravity of their condition. I don't know how to even really look her in the eye when I talk to her, knowing we're lying about what's going on. I don't know how her son keeps this secret. And I'm pretty sure one of us is bound to slip up and accidentally say something within earshot... and then what? If she gets a roommate, it's going to be awfully confusing if the roommate starts asking what she has, because this isn't the "infection" floor and she's not being seen by the "infection" doctors.
Not to be silly about it, but if this is okay, ethically speaking, then where's the line? What if she really did have just an infection, but her son was worried she wouldn't take that seriously enough, and that in order to scare her into cooperating with treatment, we should tell her she has cancer. Would that be okay? Surely not. At least I assume not! But what's the difference, really?
A mentally competent patient, who's being robbed of her ability to make her own choices about her treatment and her life, and being lied to about her medical condition, just because her family assumes they know what's best. But we're the ones charged with knowing what's best, not her son. At least not without a court order.
But what do I know, I'm just an intern.
Seriously, am I wrong here? Is this standard practice? Is it ethical practice? Is it even legal practice??