Disclosing the Truth: A Dilemma between Instilling Hope and Respecting Patient Autonomy in Everyday Clinical Practice

Sarafis, Pavlos; Tsounis, Andreas; Malliarou, Maria; Lahana, Eleni

doi:10.5539/gjhs.v6n2p128

Cited by 48 publications

(49 citation statements)

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“…Kazemi et al evaluated 200 physicians and reported that participants stated that their decision would be dependent on the patient's condition and cultural and social issues (19). The results indicate that truth disclosure varies in different cultures and the extent of information provided to patients is also different depending on their gender, age, cultural and social background and a number of specific factors that are different for each person (20). Thus, when disclosing the truth, personality, culture, religious beliefs, and ethnicity of patients must be taken into account (21).…”

Section: Discussionmentioning

confidence: 99%

Truth Disclosure to Patients with Poor Prognosis: A Comparison of the Perspectives of Patients, Physicians and Nurses

Bagheri

Dehnoalian

Hosseini

2017

Jundishapur J Chronic Dis Care

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Background: Truth disclosure to patients is the cornerstone of medical ethics. However, perspectives are variable regarding telling the truth and disclosure of bad news to patients in different communities and cultures. Also, physicians, nurses, and patients have different perspectives in this respect. All these factors are responsible for the ongoing debate regarding the disclosure of truth to patients with poor prognosis. Objectives: This study aimed at assessing the perspectives of patients, physicians, and nurses regarding disclosure of disease status to patients with poor prognosis. Methods: This descriptive cross-sectional study was conducted at Neyshabur University of Medical Sciences, during year 2016. A total of 215 participants, including 105 nurses, 30 physicians, and 80 patients were selected using stratified random sampling. A researcher-designed questionnaire comprised of 3 parts was used to collect the data. It contained 7 questions regarding demographic information, 17 questions regarding the perspective of the participant about telling the truth, and 10 questions on factors affecting the decision of physicians and nurses regarding disclosure of disease information to patients with poor prognosis. The data was analyzed using the SPSS version 20 software, with descriptive indexes and Pearson correlation, chi-square, and one-way

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Section: Discussionmentioning

confidence: 99%

Truth Disclosure to Patients with Poor Prognosis: A Comparison of the Perspectives of Patients, Physicians and Nurses

Bagheri

Dehnoalian

Hosseini

2017

Jundishapur J Chronic Dis Care

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“…It is highly relevant for clinical practice ranging from decision making for treatment option to palliative care [2]. There remains a strong resistance against disclosure of diagnosis and prognosis in terminally ill patients, because of the fear of causing despair to patients [3]. Although a protocol for breaking bad news was proposed [4, 5], disclosure practices are far from being the norm in many countries [3], and most of the physicians lacked the essential knowledge and skills for breaking bad news [6].…”

Section: Discussionmentioning

confidence: 99%

“…There remains a strong resistance against disclosure of diagnosis and prognosis in terminally ill patients, because of the fear of causing despair to patients [3]. Although a protocol for breaking bad news was proposed [4, 5], disclosure practices are far from being the norm in many countries [3], and most of the physicians lacked the essential knowledge and skills for breaking bad news [6]. Having a cancer causes psychological problems and cancer patients have higher suicide risk [7–9].…”

Section: Discussionmentioning

confidence: 99%

Considering Patients’ Mental Capacity When Giving Them Bad News May Help Their Well-Being: A Case of Suicide Attempt after Being Informed of Lung Cancer Diagnosis

Kobayashi

Kato

Takeuchi³

2014

Case Reports in Psychiatry

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Mental capacity is a central determinant of patients' ability to make autonomous decisions about their care and deal with bad news. Physicians should be cognizant of this when giving patients bad news in efforts to help them to cope with the illness and to avoid a deterioration of their mental well-being. To show the importance of this concept, a case of suicide attempt with lung cancer is exemplified. A 76-year-old woman attempted suicide after receiving a diagnosis of lung cancer. Her recent life had been emotionally turbulent and she did not have sufficient mental capacity to accept and cope with this truth. She developed depression before attempting suicide.

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“…It is confirmed even in contexts where social practices are traditionally ''protective.'' 9 Thus, the importance of the question does not lie in the claim of an absolute value of autonomy, but as Article 5 of the United Nations Educational, Scientific and Cultural Organization (UNESCO) Declaration of Human Rights and Biomedicine paradigmatically states, in the respect of ''the autonomy of persons to make decisions.'' 10, 11 More precisely, to make decisions that influence one's own end of life within the healthcare system.…”

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confidence: 99%

Editorial

Monteverde

2017

Nurs Ethics

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Death is certain, its hour is uncertain. For centuries, this ancient truism has been a strong motif in the figurative arts, a source of religious and political control, intellectual creativity, and social commitment. It has also been a foundational concept for nursing, long before it became a professional practice and science. Nursing has always had a strong voice in favor of people who are suffering, being present at their bedside and giving empathic care to the living and the dying, helping people to cope with the certitude of death and the uncertainty of its hour. An expression of this ''natural'' endeavor of nursing can be found in the preamble to the code of ethics of the International Council of Nursing, which states that ''. .. Nurses have four fundamental responsibilities: to promote health, to prevent illness, to restore health and to alleviate suffering,'' 1 and culminates in stating that ''The need for nursing is universal.'' This special issue of Nursing Ethics explores different perspectives and possible future directions of this commitment in the context of assisted dying. There is a need for a deeper analysis from the perspective of nursing ethics in the light of actual and potential legislative changes globally. This editorial includes short summaries of some of these changes from members of the Editorial Board of Nursing Ethics. They reflect the situation of countries where legal provisions and/or societal debates have emerged that necessarily involve the engagement of nurses. Knowing about the finitude of life is particular to human beings. In the context of breathtaking advances in medical science in prolonging biological life, the palliative care approach translated what it meant to alleviate suffering under the conditions of modern medicine. It became a reminder that death and dying are not to be seen as blind spots in a medical system that creates health, but as integral aspects of life that call for a response that is both compassionate and effective. As societies change, truisms become challenges. In industrialized nations, both the certitude of death and the incertitude of its hour seem to be put under scrutiny. One major reason is the success of medicine in avoiding preventable death and in refining constantly what ''preventable'' means. As to the certitude of death, the dispute about the definition of death by neurological criteria is restarted each time some refined understandings about how the brain works are presented. The legal battle of the parents of Jahi McMath in California, who succeeded in questioning the validity of her daughter's death certificate, may be seen as an isolated tragic situation, but it stands as a symbol for the challenges surrounding the declaration of death under the conditions of modern medicine. 2 As to the incertitude of the hour of death, planning one's own end of life turns up as a social imperative alongside the technological imperative of medicine. Many industrialized nations have introduced legislation on advance directives, confirming the validity of...

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Disclosing the Truth: A Dilemma between Instilling Hope and Respecting Patient Autonomy in Everyday Clinical Practice

Cited by 48 publications

References 46 publications

Truth Disclosure to Patients with Poor Prognosis: A Comparison of the Perspectives of Patients, Physicians and Nurses

Truth Disclosure to Patients with Poor Prognosis: A Comparison of the Perspectives of Patients, Physicians and Nurses

Considering Patients’ Mental Capacity When Giving Them Bad News May Help Their Well-Being: A Case of Suicide Attempt after Being Informed of Lung Cancer Diagnosis

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