Offering Truth: One Ethical Approach to the Uninformed Cancer Patient
Archives of Internal Medicine. 1993 Mar 8; 153(5): 572-576.
The problem of the uninformed patient with cancer can be described in many different ways, for example, as faulty physician-patient communication; as an obstacle to good medical care; as a cause of stress among hospital staff; and as a failure to respect patient autonomy. A dimension at least as important as these, but rarely acknowledged, is the clash it may represent beween diverse cultures and their basic moral commitments. The approach presented above reflects an effort to maintain accepted standards of the physician-patient relationship while respecting the cultural background and requirements of families. This form of respect involves reasonable accommodation to these cultural expectations but should not be confused with uncritical acquiescence. The critical question is, perhaps, this: How should we react to a family that refuses to allow the patient an offering of truth, that maintains that discussion itself to be contrary to cultural norms? Under those circumstances, I believe the offering must be made notwithstanding family demands. My reasons have as much to do with my beliefs about the nature of ethnic and religious moral norms themselves as with the view that in cases of conflict, our public morality (as concretized in law) should prevail.
Autonomy; Cancer; Case Studies; Communication; Consent; Consultation; Decision Making; Diagnosis; Disclosure; Ethicists; Family Members; Informed Consent; Law; Moral Policy; Morality; Nature; Patient Care; Patient Care Team; Patient Participation; Patients; Physician Patient Relationship; Physicians; Prognosis; Referral and Consultation; Standards; Terminal Care; Third Party Consent; Truth Disclosure;
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