Ethics in medicine: students' opinions on disclosure of true diagnosis

To determine students opinions about diagnosis disclosure to the patient and other interested parties.

During 2000/2001 academic year, an anonymous survey was conducted among the first-year (200 questionnaires) and sixth-year medical students (200 questionnaires) at the Zagreb University School of Medicine. Students were asked what they would say about the diagnosis to the patient, patients family, friend, employer, colleague from work, health insurance agent, another physician, or medical student, if the diagnosis was inoperable lung carcinoma in a 20- and 66-year-old patient vs bacterial pneumonia in patients of the same age. The possibilities were to tell the truth, lie, or refuse to disclose the diagnosis.

The response rate was 55%. Students would disclose the true diagnosis to the patient, patients family, friend, and employer in case of benign disease more often than in case of malignant disease (p<0.001). Patient's age did not affect students' opinions. Most students would rather refuse to say anything than lie if they would not want to say the truth. Students would more often tell the truth to the patient and patient's family then to a health insurance agent, another physician, or medical student, less often to patient's friend and employer, and rarely to the patient's colleague from work. First-year students would generally tell the truth more often than sixth-year students (p<0.001). There were almost no differences in the opinions between male and female students.

The strongest influence on students choice on whether or not to disclose the diagnosis had the severity of disease, person they would disclose the information to, and the academic year they attended, implicating that such important ethical issues should be discussed during the studies.