Mrs. Romero, an 85-year-old widowed Filipino female who still has the capacity to make her own decisions, was accompanied by her daughter for a follow-up visit. A few days earlier, the daughter had received a message from the doctor’s office regarding Mrs. Romero’s bronchoscopy results and was advised to return to the office with her mother as soon as possible. The purpose of this appointment was to discuss the test results and plan of care. The physician approached the daughter before meeting with the patient, and told her about the results, which were positive for metastatic non-small-cell cancer non-responsive to any treatment.
After learning this, the daughter requested that the physician not disclose the results to her mother in order to protect the older woman, prevent despair, and maintain hope. The daughter maintained that her mother had a delicate emotionally-labile personality and would be unable to handle such sensitive information. Mrs. Romero would definitely be devastated and might become severely depressed. The daughter, having understood that there was no treatment option available to prolong her mother’s life, decided to take her mother home with hospice.
As the healthcare provider, you are not quite sure what to do. You feel very uncomfortable not sharing such information with the patient, whom you feel has the right to know, and yet the daughter is adamant that you not tell her mother the diagnosis.
Discussion Topics
1. How can cultural beliefs and practices influence rules for disclosing or truth-telling regarding terminal health diagnoses?
2. List some interventions that could foster and improve communication between the healthcare provider and the family members when dealing with requests for non-disclosure of serious health conditions to the patient.
