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Advance directives for truth disclosure.

Dominic T Keating¹, Kayser Nayeem, J J Gilmartin

¹Department of Respiratory Medicine, Unit 4, Merlin Park Regional Hospital, Galway, Ireland.

|August 16, 2005

Summary

Most patients want to know about cancer or dementia diagnoses. Asking about disclosure preferences at hospitalization is feasible and helps clinicians honor patient wishes for medical information.

Keywords:

Empirical Approach Professional Patient Relationship

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Area of Science:

Medical Communication
Patient Autonomy
Oncology

Background:

Most patients desire full disclosure of serious diagnoses like cancer.
A notable minority prefer limited or no information.
Patient preferences for information disclosure vary.

Purpose of the Study:

To assess the value of inquiring about patients' disclosure preferences upon hospital admission.
To determine if asking about information preferences is practical in clinical settings.

Main Methods:

Survey of consecutive patients on respiratory and geriatric units.
Patients were asked about their preferences for disclosure of cancer or Alzheimer disease diagnoses.
Disclosure preferences were compared between younger and older patient groups.

Main Results:

84% of 207 patients wished to be informed about cancer or dementia.
No significant difference in disclosure preference was observed between younger and older patients (86% vs. 82%).
Patient preferences were honored in 87% of cases where a diagnosis was made.

Conclusions:

Inquiring about truth disclosure preferences at hospitalization is practical and beneficial.
Clinicians can use this information to enhance patient-centered communication.
Respecting patient wishes improves care and family communication regarding diagnoses.