Why do some people pretend to have a terminal illness?

A young man spent months trying to persuade his ex-girlfriend that he had terminal lung cancer in order to win her sympathy and so resume their relationship. A woman shaved her head and plucked her eyebrows to convince her family and friends she had cancer; another wore a T-shirt proclaiming “Cancer sucks!” in order to raise funds for her fictitious medical treatment. Why did they all tell such a big lie?

It would be easy to assume a simple explanation for most examples of this kind of lie - money - but there are often much more complicated reasons for these deceptions. To be fair, in many instances raising funds is the prime motivation. In some cases though the motivation seems to be simply to gain attention; a desire to seek validation through sympathy arising from the person's poor self-esteem. In a small number of cases the lie may be linked to a genuine mental illness.

Factitious disorders are a recognised psychiatric condition in which an illness is feigned or even fabricated. One young woman was observed causing her nose to bleed and then swallowing the blood in order to simulate an internal abdominal bleed. Sufferers will often move from hospital to hospital in order to gain attention from medical professionals, tying up limited resources and stopping them from treating the genuinely sick. In a smaller subset, often known as Munchausen's Syndrome by Proxy, an adult will fabricate an illness in a child. In extreme cases children have been deliberately poisoned by a parent in order to get attention from clinicians. The American Psychiatric Association has outlined three conditions required for a diagnosis of factitious disorder, the final one being an absence of an external motivator, such as monetary gain. In cases where terminal illness is feigned there seem to be clear motives, usually financial, so they can't fairly be described as actual factitious disorders.

Does this make these people pathological liars or sociopaths instead? A young woman told her co-workers she needed a mastectomy and they raised money for reconstructive surgery; she didn't have cancer and instead used the money for a breast augmentation. Another woman used her fictitious terminal illness to raise funds for a lavish wedding; her husband divorced her as soon as he found out, and she was charged with fraud. It seems unbelievable that these people thought they could get away with it.

Telling lies is a norm of human social interaction. Everybody lies. To a pathological liar, though, telling the truth is not an option; they lie out of habit about large and small matters. Sociopaths, on the other hand, tend to lie in order to achieve a goal, and this seems to fit most closely with people feigning terminal illness for personal gain, whether financial or otherwise. Even if due to a mental condition it cannot be considered acceptable to pretend to have cancer in order to raise funds, engender sympathy, or just to gain attention.

It is worth considering the attitude of people unfortunate enough to actually have a terminal illness. Knowing that their life is limited causes many to live each day to the full. Things that they have always wanted to do are suddenly given priority. Things they have always wanted to say to friends and loved ones, but where the time was never right, are now spoken. With a clear understanding of the value of each moment, they relish life 24 hours a day.

Whilst not all people with a terminal illness are able to reach this state of mind many of them do, and there is a lesson in that for all of us. Life is finite. Make the most of it.

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