'It can't just be. I'm afraid you're wrong'

This quotation introduces the reader to an article on death denial (1). How to deal with a patient who "refuses to accept the diagnosis of a terminal illness"? You wonder what might be wrong about denying, yet you are assured that it is wrong. "A maladaptive mechanism" . "Fortunately in such circumstances denial usually dissipates as the disease progresses, and acceptance of death emerges." Fortunately? . . . Yes, since:  "denial [may] interfere with daily life and medical treatment." "If detrimental to the dying process, therapeutic strategies are available to help physicians to deal with, and potentially resolve, denial, and while doing so, promote dignified and peaceful death."

Journal of Clinical Oncology is the leading academic journal on cancer, and if proclaiming that denial has to be treated, oncologists are  asked to obey. Buckman's six-step protocol and Balban's  four-step approach "should be appropriate for dealing with, and potentially resolving denial."

Cancer and metaphysics

Even on your death bed you cannot escape medical metaphysics and the negative  influence of religion. Academic doctors rob you of your hope, and urge you to prepare for a "dignified and peaceful death". Otherwise they have to treat you. Despite their expertise oncologists do not know why a cancer patient dies and when will he pass away.  "Terminal disease" summarizes their viewpoint. Since all means to treat the tumor failed, and it resists  further treatment, patient is doomed, and has to be prepared for a "dignified death". They ignore  'non-scientific' treatments of alternative medicine, and turn to Buckman's six-step protocol to suppress hope.

WOB and Mind

Even at this advanced stage, wisdom of the body (WOB) controls cancer, since when losing control, patient dies. WOB task is to maintain life and it is unaware of any danger or imminent death, which are conveyed to it by the mind. When mind faces a threat it sends WOB a message of fear meaning: "Danger! Escape!" and WOB obeys. Some messages of the mind are false, like when imagining a devil, which  generates the same fear message: "Danger Escape!".  The notion of 'dying' also originates in the mind.
WOB is unaware of imminent death. Even now while the  patient is dying, WOB maintains life. 'Dying' is a term used by physicians to communicate their clinical impression. It is a phase of life, and lacks any independent meaning. Only death is meaningful because it is an end point when WOB ceases to operate. Even on his death bed the patient may feel good when WOB is at ease. Yet  'Dying' worries his family because they believe in their doctor. They communicate their anxiety to the patient. His mind sends WOB a futile message of danger. WOB mobilizes its depleting resources and wastes them on a needless cause. Wasting resources means health deterioration. Some patients succeed averting this danger for a while by denying death, while others die.


1. Rousseau P. Death Denial J. Clinical Oncology 18:3998,2000.

Patient Physician
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