It’s something that happens all the time between doctors and patients, but it’s a deceptive practice.

That’s what G. Jay Westbrook, director of palliative care training at Stanford University’s School of Medicine, said about physicians withholding information or providing sugar-coated answers to their terminally ill patients. He addressed a crowd gathered at the annual conference of the Association of Heath Care Journalists in Santa Clara, Calif.

He would know its detrimental effect, but not because of his profession.

In emotional detail, Westbrook described the 2012 death of his wife of nearly 43 years to pancreatic cancer. The event inspired him to research the importance of frank end of life conversations between patients, families and physicians.

“I live with a lot of pain, I reframe that pain to teach physicians, patients, families,” he said. “That pain is a small price to pay for a life-long love affair.”

Holding a plastic cup of water, Westbrook then asked the audience to decide if it was half-full or half-empty. The glass was completely full, he said, because it was filled half with air and half with water. His point: patients facing terminal disease should not be afraid to learn the truth about their condition.

“Learning how to look at life and end of life differently becomes one of the greatest skills that we can develop as clinicians and as families,” he added. “Nancy was a horticulturist and was married to an end of life bedside clinician for over a quarter-century, but our lives didn’t intersect very much. When she was diagnosed with pancreatic cancer, she certainly did not want to know very much.”

Doctors advised Nancy that with proper treatments, she could live one year. Nancy hoped to live at least 14 months. She only lived about seven, which her husband had predicted months before.

To help other families avoid painful misunderstandings, Westbrook developed a list of key recommendations that terminally ill patients and their families should ask doctors: How long will treatments change survival time; how will treatments affect the patient’s “functional mentality” or quality-of-life; ask medical providers for the truth to be told as plainly as possible.

Clinicians often confuse laypeople with terms such as “positive,” “dignity” and “pain.”

“Don’t use the word ‘grave’ to mean important, because nobody does that except physicians,” he added. “There’s a difference between saying to someone, ‘I want you to understand that I will do everything I can to get you out of this pain’ or ‘I am going to do everything I can to get you comfortable.’ The last word is ‘pain’ or ‘comfortable’ and that’s what the patient is going to focus on.”

Forty percent of oncologists caring for end-stage patients lie about their life-expectancy, according to a seminal 2001 study. Just 37 percent said they told the truth.

“Some lie to get them to tie up their affairs, telling them they had less time,’ Westbrook said. “Others told their patients they had more time so they didn’t take away their hope. Neither is acceptable.”