Dealing with death in cancer care: should the oncologist be an amicus mortis?

Abstract

The way death is (not) dealt with is one of the main determinants of the current crisis of cancer care. The tendency to avoid discussions about terminal prognoses and to create unrealistic expectations of fighting death is seriously harming patients, families, healthcare professionals, and the delivery of high quality and equitable care. Drawing on different literature sources, we explore key dimensions of the taboo of death: medical; policy; cultural. We suggest that the oncologist, from a certain moment, could take on the role of amicus mortis, a classical figure in the past times, and thus accompanying patients towards the end of their life through palliation, and linking them to psychosocial, and ethical/existential resources. This presupposes the implementation of Supportive Care in Cancer, and the ethical idea of relational autonomy based on understanding patients’ needs considering their sociocultural contexts. It is also key to encourage public conversations beyond the area of medicine to re-integrate death into life.