Question

A physician receives the pathology report from a recent endoscopy of her patient, a 78-year-old Japanese man. The report reveals adenocarcinoma of the stomach. The physician intends to disclose the diagnosis to the patient. However, as the provider approaches the patient’s room, the patient’s daughter stops her. The daughter demands to know the diagnosis and states that, if indeed it is cancer, her father should not be told. The daughter insists that she and her mother will decide what is best for her father. She argues that in her father’s culture, family members make the decisions for the patient.

Consider these related questions: ● Is it the physician’s duty to disclose the truth to her patient? ● How can the physician-patient relationship be preserved while taking into consideration the wishes of family members? ● What role should culture play in how a case is handled?

Answer 1

Is it the physician’s duty to disclose the truth to her patient?

Yes, it is the physician’s duty to disclose the truth to her patient.

How can the physician-patient relationship be preserved while taking into consideration the wishes of family members?

• The focus should continue on the patient. Physicians should support family caregivers to preserve the honor and freedom of their dear ones.
• The physician should frequently consider the patient’s choices concerning the nature and extent of caregiver involvement in the decision making and try to give the craved state of privacy to the patient.
• Physician openness and outstanding communication are significant in strengthening the patient and family caregiver.

What role should culture play in how a case is handled?

Cultural beliefs can influence a patient's decisions on who to take care of and from whom, how he or she will handle own-care, how he will get health decisions, and how she might react to a particular treatment. Cultural concerns present a pivotal part in the agreement, which is a person's readiness to accept the doctor's instructions.