Chinese and U.S. internists adhere to different ethical standards

Area of Science:

• Medical Ethics
• Cross-Cultural Healthcare
• Oncology Communication

Background:

• Understanding cultural variations in medical practice is crucial for effective global healthcare.
• Physician communication regarding terminal diagnoses and end-of-life care significantly impacts patient and family experiences.

Purpose of the Study:

• To compare the ethical beliefs and practices of internists in the United States and China.
• To investigate differences in patient disclosure, family involvement in decision-making, and views on assisted suicide.

Main Methods:

• A structured questionnaire with clinical vignettes and multiple-choice questions was employed.
• Interviews were conducted with 40 practicing internists (20 in the US, 20 in China) from university and community hospitals.

Main Results:

• US internists were significantly more likely to disclose cancer diagnoses (95% vs. 0%) compared to Chinese internists.
• Both groups were highly likely to disclose an acquired immunodeficiency syndrome (AIDS) diagnosis (100% US, 90% China).
• Chinese internists (65%) were more inclined to follow family preferences over patient wishes in advanced cancer treatment decisions than US internists (5%).

Conclusions:

• Significant disparities exist in clinical ethical beliefs between US and Chinese internists, particularly concerning cancer diagnosis disclosure.
• Chinese physicians generally place greater emphasis on family preferences in medical decision-making compared to their US counterparts.
• Cultural factors profoundly influence end-of-life care communication and decision-making processes in medicine.