**1. Introduction**

The educational standard of people living in low- and middle-income countries is very low, with one-third of its youth dropping-out of school before secondary level of education [1]. The literacy level among graduates of tertiary educational institutions in most low- and middle-income countries is also low [2]. On account of this poor literacy rate, majority of people living in these countries depend on healthcare professionals for information about health and illness [3]. A similar situation exists in Ghana, a lower middle-income country.

The burden of chronic non-communicable diseases in Ghana is rising [4], and the importance of patients and their families understanding the disease they are suffering from, the treatment modalities available, and the objective of each modality is crucial to adherence to therapy [5–7]. However, in the course of caring for patients in the last few months to a year of life, the author has noted a generally poor level of knowledge among patients and families about the disease affecting

them and the objective of therapy they have sometimes received for several months. They, therefore, present to the palliative care unit with expectations of cure and expressions of feeling of anger at and disappointment with healthcare professionals for not being open to and honest with them from the beginning.

This article has therefore been addressed to colleague health professionals as a letter, to highlight the voices and cries of these patients and their families, and to appeal to healthcare professionals to involve them actively rather than passively in their care.
