[Dialectic of hope in patients with a limited life expectancy. Ethical and narrative aspects].

Abstract

The patient's right to know his/her clinical information corresponds with the duty of the health care professional, especially the physician responsible for his/her care, to provide it. However, in the case of patients whose life prognosis is limited, this presents several difficulties. Determining the content of this right is complicated because it depends on the circumstances. This favors the conspiracy of silence, the main cause of which can be found in the maintenance of the patient's hope. However, condemning the patient to a false hope prevents him/her from developing a grieving process, that requires renouncing that hope and embracing another undetermined hope of open content. In this work we try to outline the structure of this dialectical process, which can be explained, in narrative terms, through the structure of the heroic myth, which is functional even when the energetic structure of the moral character is missing and which is adjustable for each person.