Lerer B, Avni J, Wiesel D
Ment Health Soc. 1976;3(3-4):205-11.
The physician in hospital practice may be faced with a situation in which a patient under his care suffers a bereavement or some other unexpected tragedy but is unaware of the fact. Three such cases encountered in the context of our psychiatric sonsultation service are presented. Factors influencing the decision as to whether, when and how the patient should be informed are considered. The complex psychodynamic situation which arises and involves the patient, his family and the medical staff is described. Stress is laid on the role played by archaic fears of being the bearer of evil tidings. The situation is seen as being ideally handled by the direct treating physician in conjunction with the family, the extent of psychiatric intervention being dictated by the needs of each of the parties concerned. Ideally the patient should be told as soon as his physical and mental condition are seen as conducive and preferably before he leave hospital.
他所照料的患者遭遇了亲人离世或其他一些意想不到的悲剧，但患者本人却不知情。本文介绍了在我们的精神科会诊服务中遇到的三起此类病例。文中还考虑了影响决定是否、何时以及如何告知患者这一情况的因素。描述了由此产生的涉及患者、其家人和医护人员的复杂心理动力学状况。强调了因古老的恐惧——害怕成为坏消息的传递者——所起的作用。这种情况被视为由直接负责治疗的医生联合患者家属来理想地处理，精神科干预的程度则由相关各方的需求决定。理想情况下，一旦认为患者的身心状况适宜，就应尽快告知他，最好是在他出院之前。
