Bioethics of Information Disclosure Across Cultures: "Don't Talk with Her About Her Condition" Public Deposited

Healthcare providers are routinely faced with the bioethical challenges of information disclosure across cultures. This paper analyzes the case study “Don’t Talk with Her about Her Condition” (Center for Ethics in Health Care at OHSU; See Appendix A). The impact of full, partial, or non-disclosure of information to a patient greatly varies in different cultural contexts. While information disclosure emphasizes patient autonomy and informed decision-making, it also can be controversial to improving patient safety. In some cultures, the disclosure of a negative diagnosis or prognosis can pose significant risk to the patient’s health, so the patient family takes responsibility of the treatment decision-making process. American values are adopted by people of other cultures to various degrees, so it is crucial to appropriately communicate and administer care services without violating the values and cultural norms of patients and their families. Providers must remember that patients have the ultimate right to decide how their individual autonomy is exercised, which may mean non-disclosure and the assignment of a surrogate. Therefore, it is equally important to uphold beneficence and the role of the family and community in patient care. The recommended approach for information disclosure is asking patients for their desired level of participation and how much information they want to know with respect to their own illness. This approach takes into account the perspectives of the patient, the patient’s family, and the provider care team across cultural contexts. In patient-provider communication, it is imperative that cultural and individual sensitivities in information disclosure are respected and understood.

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