Doctor Stover : Joshua, you know from speaking with Dr. Hassan that the cancer h

Question

Doctor Stover: Joshua, you know from speaking with Dr. Hassan that the cancer has reappeared in your colon.

Joshua: Yes.

Doctor Stover: Did Dr. Hassan explain what happens from here?

Joshua: Yeah. He said that the treatment didn’t work. He didn’t recommend chemotherapy. It sounds like it wouldn’t really help much and might make me feel more miserable. He said I only have a few months left. Honestly, it’s a lot for me to think about. I haven’t been sleeping well.

Doctor Stover: Well, I looked at the report sent by Dr. Hassan. I completely understand how you might feel overwhelmed. I want you to know that I am here to answer any questions. I also want you to know that even though the chemotherapy is not recommended, there are a lot of things we can do to help you feel comfortable during this time. As you probably know, I have a whole team of highly skilled health professionals who are ready to help make sure you feel as well as you can for as long as you can. Do you want me to tell you a little about them and what they can do?

Joshua: (Sigh) Sure.

Brian (Joshua’s same-sex partner): Yes, that would be really helpful.

Doctor Stover: So we can predict and start to address some of the emotional and physical health problems that will arise in the next couple of months. We can try to prevent them and treat them as soon as they rear their heads. We will keep a close eye on your emotional and physical state, with regular check-ins. But before we discuss the details, Joshua, is there anything in particular you want to discuss first?

Joshua: Yes. I am really concerned about Brian. I just want to be sure that he’ll be able to cope with everything once we get home. He takes really good care of me, but I don’t want him to be overwhelmed too. He’s going to need a lot of help.

Doctor Stover: People usually want to be independent as long as possible. If you want to stay home rather than in a hospital that is very understandable. But it can be a lot of work for partners. That’s why we are going to have you work with a whole team of specialists in medicine, palliative care, and palliative nursing. Nancy, our care coordinator, is going to give you more information about each of the team members and will make sure they are working together as a cohesive unit to meet your needs.

Joshua: Thanks. That sounds good.

Why is it important that Doctor Stover is including Brian in this conversation? (1-2 paragraphs)

Stover is worried that telling Joshua chemotherapy would be futile would only worsen the depression. Would it ever be appropriate for Doctor Stover to recommend chemotherapy simply to have Joshua keep hope alive? Why or why not? (1-2 paragraphs)

Explanation / Answer

One of the most important reasons to include Brian in the conversation is that he is the same sex partner of Joshua which means he will be the one who would be affected greatly with whatever happens to Joshua. If he knows what's really going on, he could help Joshua with lots of positive activities and understand him better. This would further enable him to look for avenues where Joshua will be happy and content until his last breath.

Secondly, Brian needs to plan his daily life as well because if Joshua is going to be at home, Brian should either sacrifice his work or arrange someone to take care of Joshua. This may also bring lots of stress on Brian but if he knows the reality it would help him plan the future activities better.

Dr. Stover would have just lied in order to satisfy Joshua and keep him happy until his death but it would be very disappointing for Brian because he would expect Joshua to get cured. It would result in lack of trust on doctors and Brian would feel deceived. Brian would become heartbroken when he finally sees Joshua die despite the doctor's words.

Secondly, if he suggests chemotherapy, Joshua would undergo lots of pain without any result. If the therapy works, it's worth undergoing that pain but in the event that it wouldn't work, he would feel like tortured. At least if he knows that there is no hope, he would save the pain and prepare well for a meaningful death.

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