“Secrets and Lies”: (Not) Telling Bad News in Italian Oncology

Abstract

The problem that I treat in this paper is about the fact that people who are about to die in hospital are not usually informed about the fate awaiting them. In Italy, this attitude has remained intact over time despite the extraordinary changes which have taken place in clinical techniques and therapies, and despite the spread of hospices and palliative care wards. In this paper I shall describe the strategies adopted by Italian oncologists to prevent the dying from knowing their fate, the exceptions to this rule, and some of the structural and organizational factors which make changing the situation difficult. The discussion conducted in this paper is based on an ethnographical research carried out by the author in a large hospital in northern Italy.

Keywords

• Imminent death
• Conspiracy of silence
• “No tell” policy
• Communicative strategy.