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Related Experiment Videos

Breaking bad news: a Chinese perspective.

C Y Tse1, Alice Chong, S Y Fok

  • 1United Christian Hospital, Kowloon, Hong Kong. cytse@ha.org.hk

Palliative Medicine
|June 26, 2003
PubMed
Summary

Terminal cancer patients in China often don't receive full information due to family objections. Research suggests patients desire truth, advocating for disclosure based on patient wishes, not family preferences.

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Area of Science:

  • Medical Ethics
  • Oncology
  • Cross-Cultural Studies

Background:

  • Information disclosure to terminal cancer patients varies globally, with significant cultural differences observed in China.
  • Many Chinese families prefer withholding information from patients, a practice doctors often adhere to.
  • A Hong Kong study indicated a majority of patients desired to know about their illness.

Purpose of the Study:

  • To analyze ethical principles regarding truth-telling for terminal cancer patients in the Chinese cultural context.
  • To reconcile differing attitudes towards information disclosure between patients and families.
  • To propose culturally sensitive recommendations for palliative care communication.

Main Methods:

  • Ethical principles for and against disclosure were analyzed.
  • Consideration of Chinese philosophy, sociological studies, and traditional Chinese medicine perspectives.
  • Review of existing population studies on patient information preferences.

Main Results:

  • Chinese views on autonomy and nonmaleficence do not inherently justify withholding truth from patients.
  • Patient desire for information contrasts with common family practices of non-disclosure.
  • The Hong Kong study highlights a significant patient preference for receiving information.

Conclusions:

  • Truth-telling should be guided by patient autonomy and their willingness to know, not solely by family wishes.
  • Standard palliative care approaches for breaking bad news are recommended.
  • Modifications are needed to address cultural factors like 'family determination' and the taboo surrounding death.

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