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disclosure

An element necessary of informed consent: - ensuring a patient has all the information he/she needs to make an informed decision. (also see autonomy) - in general, physicians often underestimate how much information the patient desires. - 2 competing standards for disclosure have been used in court cases: a) older standard 'professional practice' determined by professional practices in physician's community b) 'reasonable person' is what a reasonable person would want to know to make a decision Management: - ask the patient about their preference for disclosure & participation in medicial decisions (preferable as a part of advance directives) - if the family requests a patient should not be informed of a serious or terminal diagnosis, ask the family their reason for withholding the diagnosis [2] Notes: - patients are more likely than family to prefer full disclosure of a cancer diagnosis (including Middle-Eastern patients) [2,4,5,6]

Related

autonomy conflict of interest discussing poor prognosis informed consent/refusal

Specific

disclosure of unanticipated outcome

References

  1. Kapp M & Finucane T. Decision Making, In: Comprehensive Geriatric Assessment, Osterweil et al eds, McGraw-Hill, New York, pg 590-91
  2. Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013 - Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  3. Weinfurt KP, Hall MA, King NM et al Disclosure of financial relationships to participants in clinical research. N Engl J Med. 2009 Aug 27;361(9):916-21 PMID: 19710491
  4. Adelekan A, Alrashah AS, Al Hutaylah IS et al. Preferred medium of receiving diagnostic news depending on patients' perception of their health status (healthy or sick). Patient Prefer Adherence. 2020;14:903-1915 PMID: 32581517 PMCID: PMC7269663 Free PMC article https://www.dovepress.com/preferred-medium-of-receiving-diagnostic-news-depending-on-patientsrsq-peer-reviewed-fulltext-article-PPA
  5. Alsirafy SA, Abdel-Kareem SS, Ibrahim NY et al. Cancer diagnosis disclosure preferences of family caregivers of cancer patients in Egypt. Psychooncology. 2017;26(11):1758-1762 PMID: 27362334 https://onlinelibrary.wiley.com/doi/10.1002/pon.4206
  6. Alzahrani AS, Alqahtani A, Alhazmi M et al. Attitudes of cancer patients and their families toward disclosure of cancer diagnosis in Saudi Arabia: a Middle Eastern population example. Patient Prefer Adherence. 2018;12:1659-1666 PMID: 30214168 PMCID: PMC6126501 Free PMC article https://www.dovepress.com/attitudes-of-cancer-patients-and-their-families-toward-disclosure-of-c-peer-reviewed-fulltext-article-PPA