Death is a reality and it is a word that must be used. I'm wondering why it would not be considered ethical.

Not all patients can and will be cured. It's a sad fact, but it is true. By not acknowledging that death possible or probable, the doctor is taking away the patient's ability to continue with the time he or she has left in the manner that they want.

Many years ago, when I was a new nurse, we would often have patients who did not know they were dying. Their families would not allow us to tell them. Even then, I knew that was wrong. First of all, in my very strong opinion, they know they are dying. And, if they know it, how must they feel if the also know that no-one around them will allow them to talk about it? HOw can they tie up loose ends - if they have any - if no-one will acknowledge that they will die?

As for doctors mentioning death while speaking to patients, if you have a potentially fatal illness, how can this not be addressed? It would be like an elephant in the room for those who know.

Many years later, I worked in palliative care, where death was an every day event. The sad thing is, because many patients hadn't really been prepared for dying, dealing with it in the final days were often more difficult than maybe they could have been.

As a society, we need to talk about death openly, as a topic that is a part of life. It shouldn't be the taboo it is now. By talking about it, we don't make it any less sad when it happens, but it makes it a more acceptable issue, one that people may not fear so much.

At the same time, it's ethically immoral for a doctor to simply throw around the word "death" and "dying" or imply such an impending event to the patient when there's no evidence to support that claim. I've known people who were diagnosed as about to die, and the diagnosis/prognosis was incorrect.

I can personally connect to this issue with my breast cancer prognosis. My oncologist felt I would most probably beat the cancer, but I sought a second opinion just because it felt like the right thing to do. For the second-opinion doctor, I brought up the issue of having children (I wanted to be a mom and harvest my eggs). This second-opinion oncologist told me, and I quote: "Why would you want to have a child -- if only to make him/her an orphan?"

I left his office in tears, feeling I was doomed to die young.

Egg harvesting didn't happen, but I am pleased to report that, nine years after that prognosis of "death" no future, I've adopted a baby girl from China, a child whom I am sharing my future with.