When a patient is severely ill, he is often treated like a person with no right to an opinion. It is often someone else who makes he decision if and when and where a patient should be hospitalized. It would take so little to remember that the sick person too has feelings, wishes, and opinions, and has-most important of all-the right to be heard Well, our imaginary patient has now reached the emergency ward. He will be surrounded by busy nurses, orderlies, interns, residents, a lab technician perhaps who will take some blood another technician who takes the electrocardiogram. He may be moved to X-ray and he will overhear opinions of his condition and discussions and questions to members of the family. Slowly but surely he is beginning to be treated like a thing. He is no longer a person. Decisions are made often without taking his opinion. If he tries to rebel he will b e sedated, and after hours of waiting and wondering whether he has the strength, he will be wheeled into the operating room or intensive treatment unit and become an object of great concern and great financial investment He may cry out for rest, peace, dignity, but he will get infusions, transfusions, a heart machine, or a tracheostomy. He may want one single person to stop for one single minute so that he can ask one single question-but he will get a dozen people around the clock, all busily preoccupied with hi heart rate, pulse, electrocardiogram or pulmonary functions, his secretions or excretions, but not with him as a human being. He may wish to fight it all but it is going to be a useless fight since al this is done in the fight for his life, and if they can save his life they can consider the person afterwards. Those who consider the person first may lose precious time to save his life! At least this seems to be the rationale or justification behind all this-or is it? Is the reason for this increasingly mechanical, depersonalized approach our own defensiveness? Is this approach our own way to cope with and repress the anxieties that a terminally or critically ill patient evokes in us? Is our concentration on equipment, on blood pressure, our desperate attempt to deny the impending end which is so frightening and discomforting to us that we displace all our knowledge onto machines since they are less close to us than the suffering face of another human being, which would remind us once more of our lack of omnipotence our own limitations and fallibility and, last but not least perhaps, our own mortality? Maybe the question has to be raised: Are we becoming less human or more human? Though this book is in no way meant to be judgmental, it is clear that whatever the answer may be, the patient is suffering more-not physically, perhaps, but emotionally. And his needs have not changed over the centuries, only our capacity to gratify them II Attitudes Toward Death and Dying Men are cruel but man is kindWhen a patient is severely ill, he is often treated like a person with no right to an opinion. It is often someone else who makes :he decision if and when and where a patient should be hospitalized. It would take so little to remember that the sick person too has feelings, wishes, and opinions, and has-most important of all-the right to be heard. Well, our imaginary patient has now reached the emergency ward. He will be surrounded by busy nurses, orderlies, interns, residents, a lab technician perhaps who will take some blood, another technician who takes the electrocardiogram. He may be moved to X-ray and he will overhear opinions of his condition and discussions and questions to members of the family. Slowly but surely he is beginning to be treated like a thing. He is no longer a person. Decisions are made often without taking his opinion. If he tries to rebel he will b e sedated, and after hours of waiting and wondering whether he has the strength, he will be wheeled into the operating room or intensive treatment unit and become an object of great concern and great financial investment. He may cry out for rest, peace, dignity, but he will get infusions, transfusions, a heart machine, or a tracheostomy. He may want one single person to stop for one single minute so that he can ask one single question-but he will get a dozen people around the clock, all busily preoccupied with his heart rate, pulse, electrocardiogram or pulmonary functions, his secretions or excretions, but not with him as a human being. He may wish to fight it all but it is going to be a useless fight since all this is done in the fight for his life, and if they can save his life they can consider the person afterwards. Those who consider the person first may lose precious time to save his life! At least this seems to be the rationale or justification behind all this-or is it? Is the reason for this increasingly mechanical, depersonalized approach our own defensiveness? Is this approach our own way to cope with and repress the anxieties that a terminally or critically ill patient evokes in us? Is our concentration on equipment, on blood pressure, our desperate attempt to deny the impending end, which is so frightening and discomforting to us that we displace all our knowledge onto machines, since they are less close to us than the suffering face of another human being, which would remind us once more of our lack of omnipotence, our own limitations and fallibility and, last but not least perhaps, our own mortality? Maybe the question has to be raised: Are we becoming less human or more human? Though this book is in no way meant to be judgmental, it is clear that whatever the answer may be, the patient is suffering more-not physically, perhaps, but emotionally. And his needs have not changed over the centuries, only our capacity to gratify them. ========================= II Attitudes Toward Death and Dying Men are cruel, but Man is kind