Disclosure and Consent
Asian Indian families are often interdependent with the autonomy unit consisting of the patient and spouse, adult children, and key members of the extended family. As described earlier, any health care professionals in the extended family are traditionally often called on to interpret test results and help with decision-making.
Older adults who are ill may practice “closed awareness,” i.e., although they may be fully aware of the gravity of their illness, they may be unwilling to discuss openly about their illness and prognosis with their family.
Similarly, family members may request that the physician withhold information from their loved one who is ill due to the concern that the truth about the illness may negate the will to live. Thus, “Doctor saab (sir), please don’t tell Dada-ji (grandfather) that he has cancer. He will just give up and die” may not be an uncommon request from a Hindu American family.
The patient may expect the doctors to have all the answers and make all the decisions. As a result, the patient takes a passive role, answering but not asking questions, and waiting for physicians to impart their diagnosis and recommendations. Most of the time medical advice is accepted without question.