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Old 07-30-2006, 03:57 PM
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What if the patient's family asks me to withhold the truth from the patient?

What if the patient's family asks me to withhold the truth from the patient?

Often families will ask the physician to withhold a terminal or serious diagnosis or prognosis from the patient. Usually, the family's motive is laudable; they want to spare their loved one the potentially painful experience of hearing difficult or painful facts. These fears are usually unfounded, and a thoughtful discussion with family members, for instance reassuring them that disclosure will be done sensitively, will help allay these concerns. In unusual situations, family members may reveal something about the patient that causes the physician to worry that truthful disclosure may create real and predictable harm, in which case withholding may be appropriate. These occasions, however, are rare.

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Old 07-30-2006, 06:26 PM
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The family can not ask or require a doctor to withhold information from the patient. The doctor is a representative of the patient not the family. A doctor should have "informed consent" to continue with care for the patient; There are exceptions to everything, and this is no different....
1. if the patient lacks the decision-making capacity (and this is tough to do)
2. Emergency situations
3. Therapeutic privilege--where telling the information would severely harm the patient OR "undermine" the informed decision-making capacity
4. patient waives the right of informed consent

Some of the above are in the gray areas... so it's best to assess every situation before moving forward...; For kids, it is the parents who determine what should be told and not told, and it's best to ask the parent what has been told to the child so that you don't put your "foot in your mouth."
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Last edited by md90; 07-30-2006 at 06:31 PM.
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