Do we always need to tell patients the truth?

Hassn, Ahmed; Hassan, Ahmed S.

doi:10.1016/s0140-6736(05)79804-4

Cited by 21 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A good physician will always give a ray of hope as well as discuss the implications of a grave situation. [48]…”

Section: Discussionmentioning

confidence: 99%

Does the cancer patient want to know? Results from a study in an Indian tertiary cancer center

Laxmi¹,

Khan²

2013

South Asian J Cancer

View full text Add to dashboard Cite

Objective:The disclosure of the diagnosis of cancer is a distressing and complex issue. Families and doctors still do not tell patients when they have cancer in the belief that the patient does not want to know and telling him would lead to fear and depression. The aim of this survey was to evaluate the information needs of Indian cancer patients.Materials and Methods:A cross-sectional survey of 300 patients’ views was conducted with the help of an adaptation of Cassileth's Information Needs questionnaire.Results:A majority of cancer patients exhibited a strong need for information about illness and treatment. Ninety-four percent wanted to know if their illness was cancer. Most patients also wanted to know the chance of cure (92%). Age, education, and type of treatment significantly affect information preferences. Gender did not have an effect on information needs.Conclusion:This study showed that most of the patients wanted to know about their illness, treatment, side-effects, and chances of cure.

show abstract

“…A good physician will always give a ray of hope as well as discuss the implications of a grave situation. [48]…”

Section: Discussionmentioning

confidence: 99%

Does the cancer patient want to know? Results from a study in an Indian tertiary cancer center

Laxmi¹,

Khan²

2013

South Asian J Cancer

View full text Add to dashboard Cite

show abstract

“…1 The price of instantaneously extinguishing hope by following protocol without heeding the patient's feelings may be heavy, although the evidence is mostly anecdotal. 2 Here we had an unusually striking example of a mind-body response that seems intimately and pathophysiologically linked-an emotionally triggered hypertensive emergency and a devastating cerebrovascular accident. 3 At other times, it is "only" the quality of life that deteriorates irrevocably (patient 2).…”

Section: Commentmentioning

confidence: 95%

Candid to the Bitter End: Indiscriminate Disclosures

Schattner

2018

The American Journal of Medicine

View full text Add to dashboard Cite

The physician's obligation to tell the patient the full truth about his or her condition has become an established ethical principle, enabling patients' autonomy, shared decision-making, and patient-centered care. However, indiscriminate application of this obligation may at times be harmful to the patient, contradicting the old Hippocratic imperative of "first do no harm" ("Primum non nocere"), as our 2 recent short patient histories demonstrate. PATIENT 1 A 65-year-old father of 6 was diagnosed with urothelial (transitional cell) carcinoma of the urinary bladder. He was a past smoker (46 pack-years) with hypertension, dyslipidemia, and a remote history of myocardial infarction. Disease was T1N0 (stage I) and treated by transurethral resection and intravesical therapy. A second-look operation and imaging revealed no evidence of disease. One year later right loin pain developed, and computed tomography revealed right hydroureter and minimal hydronephrosis without discernible cause. Results on cystoscopy were normal, but magnetic resonance imaging suggested fullness of the right ureteral outlet. Serum creatinine increased (2.0 mg/dL), ureteral infiltration by transitional cell carcinoma was demonstrated, and nephrostomy was performed with ureteropelvic junction stent placement, creatinine normalization, and nephrostomy removal. However, he was soon readmitted with recurrent vomiting, and retroperitoneal involvement, bilateral ureteral obstruction, and creatinine 3.7 mg/dL were found. After drainage he was referred to a tertiary care center and left us very sick but hopeful. On the third hospital day he was suddenly and bluntly told by a physician, who had seen him once, that a team of oncologists, urologists, and radiologists had reviewed his data, that he had extensive unresponsive disease, and that nothing could be done. He listened in silence. A few hours later a blood pressure of 250/115 was recorded, and atherothrombotic hemiplegia developed. He was sent back to the referring hospital, where we found a broken man.

show abstract

“…To the Editor: It is unclear how diagnostic disclosure affects cognitively impaired individuals. For persons with stigmatized mental illnesses, diagnostic clarity could prove harmful 1 . Alternatively, ambiguities caused by diagnostic withholding might in the short and long term negatively affect patients and their families and caregivers.…”

Section: Memory Disorder Clinic Patients Included In the Studymentioning

confidence: 99%