Day 017 - 25 Jul 94 - Page 63
1 Q. To what extent is the input of the family of the patient
important in the management of the illness?
2 A. I think it is very important because they are
providing support. They can also, hopefully, help the
3 patient to be positive. Sometimes the treatments that we
give are quite tough, and it easy for patients to feel
4 down and lose direction at times; so the family is
extremely important in providing that support, helping
5 them to remain positive throughout their treatment.
6 Q. May I ask you this question to which by now perhaps the
answer is obvious. What view do you take or would you
7 take of this hypothetical situation, that a patient had
been misled into supposing that they had colorectal
8 cancer, let us say, or cancer of the colon, on account of
the diet that they had been eating over the last 10, 15 or
9 20 years?
A. Well, I mean, I think that would be a dreadful
10 situation for people to actually be told that sort of
information. For example, I have already mentioned this
11 question of guilt and its deleterious effect on the
patient and his potential response to treatment.
12
There is no scientific evidence to support such an
13 argument. It can only have an adverse effect on patients
and their outcome. Patients are subject to all sorts of
14 stress and, I think, you know, unless one is actually
looking after people, it is sometimes difficult to
15 actually fully appreciate the stresses that they are
subjected to, and this sort of thing, I think, is to be
16 deplored.
17 Q. Can I take it one stage further? Do you have young people
as patients?
18 A. Yes, we have children in our department.
19 Q. With cancer of colon or the rectum?
A. No. Cancer of the colon tends to occur in somewhat
20 older people but, you know, one gets it in the 20s, 30s or
40s, so relatively young people.
21
Q. Let us take somebody in their late 20s, early 30s,
22 something like that, with parents? You told us that the
input of the family in management of the illness is
23 important?
A. Indeed, yes.
24
Q. In your view, as a person who treats patients with these
25 conditions, would it matter if the parents believed that
it is their fault that the child had the cancer because of
26 the diet they had been giving it over the last year?
A. Well, I mean, again I think that would be a dreadful
27 state of affairs. As I have already indicated, the family
is of tremendous importance in giving support to patients
28 going through treatment, and for them to have this added
concern of their guilt as well as trying to get the
29 patient through the patient's guilt, I think again my
comment is that it would be deplorable.
30
MR. RAMPTON: Thank you, Dr. Arnott. My Lord, those are all
