Withholding information for the patient’s best interest was the norm in medicine for centuries. It wasn’t until 1979 that the majority of U.S. physicians said they’d tell a patient when they had cancer.
that means unsubstantiated reassurance or sugarcoating of the truth. Other times, it’s to avoid offending a patient or creating conflict, such as not suggesting to a parent that a child needs to lose weight. Or doctors may not have the heart to acknowledge themselves when a patient is declining, so you don’t get the message.
Too much information can be unhelpful and confusing, said Eric Campbell, professor of medicine at the University of Colorado and director of research at the UC Center for Bioethics and Humanities. But should a doctor decide that medical choices are over a patient’s head so they shouldn’t be mentioned or that a patient is too fragile to handle difficult news?
There is a sweet spot between protecting the patient from emotional distress and being open, said Ronald Epstein, professor of family medicine, oncology and medicine at the University of Rochester School of Medicine and Dentistry. Doctors aren’t trying to deceive patients — but empathy may get in the way of being more direct. Sometimes physicians delay disclosing a bad diagnosis until they think a patient is ready to understand and emotionally absorb the news, he said.
“My mom was clearly ready for hospice, yet my family could not get [her physician] to actually suggest it,” she said. “We were waiting for guidance — for him to tell us ‘it’s time’ — and he was waiting for us to inquire about it.”
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