Physician's attitudes towards disclosure of cancer diagnosis to elderly patients: a report from Tokyo, Japan

Kawakami, Satoru; Arai, Gaku; Ueda, Keiji; Murai, Y; Yokomichi, Hiroshi; Aoshima, Masao; Takagi, Kentarô

doi:10.1016/s0167-4943(01)00099-1

Cited by 42 publications

(34 citation statements)

References 19 publications

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“…This is in agreement with the findings from Northern Europe and Anglo-Saxon countries where they usually reveal the truth to both patients and their spouse [1,79]. In contrast, it has been found that physicians from Southern and Eastern Europe [11,13,18,20,36,66,69], Africa, France, Iran, Panama, Japan, Singapore and Saudi Arabia [9,52] agree upon the concealment of the truth [30,32,35,41,51,79,85]. However, there is an obvious shift towards disclosure observed in these nations following trends set in the US and the UK.…”

Section: Discussionsupporting

confidence: 88%

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Cancer information disclosure in different cultural contexts

Mystakidou

Parpa

Tsilika

et al. 2004

Supportive Care in Cancer

186

150

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The relationship between truth telling and culture has been the subject of increasing attention in the literature. The issue of whether, how and how much to tell cancer patients concerning diagnosis is still approached differently depending on country and culture. The majority of physicians tell the truth more often today than in the past, in both developed and developing countries, but most of them prefer to disclose the truth to the next of kin. Nurses in Anglo-Saxon countries are considered to be the most suitable health-care professionals for the patients to share their thoughts and feelings with. Nevertheless, in most other cultures the final decision on information disclosure lies with the treating physician. Regardless of cultural origin, the diagnosis of cancer affects both family structure and family dynamics. In most cases patients' families, in an effort to protect them from despair and a feeling of hopelessness, exclude the patient from the process of information exchange. The health-care team-patient relationship is a triangle consisting of the health-care professional, the patient and the family. Each part supports the other two and is affected by the cultural background of each of the others as well as the changes that occur within the triangle.

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Section: Discussionsupporting

confidence: 88%

“…Similar non-disclosure has also been reported in Japan [41,51,85], Singapore [79], and Italy [30,55].…”

Section: Introductionsupporting

confidence: 82%

Cancer information disclosure in different cultural contexts

Mystakidou

Parpa

Tsilika

et al. 2004

Supportive Care in Cancer

186

150

View full text Add to dashboard Cite

show abstract

“…This has been demonstrated in the Far East [23], the Arab world [24], Southern Europe [25], and the developing world [26]. Information in these settings is disclosed to the family, which then decides whether or not the patient should know.…”

Section: Is Disclosure a Universal Practice?mentioning

confidence: 99%

Commentary: Disclosure in Oncology—To Whom Does the Truth Belong?

2009

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Target audience: Physicians who wish to advance their current knowledge of clinical cancer medicine in risk management. LEARNING OBJECTIVES1. Summarize the meaning of the term "therapeutic nondisclosure" in the context of medical oncology practice.2. Classify the reasons for variations in disclosure practices around the world.3. Develop strategies for approaching a conversation about disclosure that respects the rights and needs of the patient and family.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTThe term "therapeutic nondisclosure" refers to a clinician's decision to withhold diagnostic or prognostic information from a patient to protect him or her from perceived harm. We present a vignette in which the son of a 75-year-old Italian born immigrant asks her physician to withhold her new diagnosis of advanced myeloma. In the U.S., trends over the last 30 years have been toward more complete disclosure of cancer-related information. This can be attributed to the evolution of research subject protections, the "war on cancer," the civil rights and patient rights movements, and the rise of hospice and palliative care. In other parts of the world, however, therapeutic nondisclosure is still commonly practiced. Here, we de-

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“…Aged patients, in particular those patients presenting with poor health status and low socio-economic support, may be at increased risk for not receiving adequate care and information and hence exclusion from the decision making [13]. Kawakami et al [14] reported that the decision of not informing older patients is generally made by the family or medical staff.…”

Section: Resultsmentioning

confidence: 99%