Revisiting the truth-telling debate: A study of disclosure practices at a major cancer center

Journal of Clinical Ethics

Volumn 11, Issue 3, 2000, Pages 251-259

  Anderlik, Mary R ^a   Pentz, Rebecca D ^b   Hess, Kenneth R ^c  

^a UNIVERSITY OF HOUSTON   (United States)

^b UNIVERSITY OF TEXAS   (United States)

^c UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CANCER CENTER; CULTURAL FACTOR; DOCTOR PATIENT RELATION; EMPIRICAL APPROACH; ETHNIC GROUP; HUMAN; HUMAN RELATION; INTERPERSONAL COMMUNICATION; MEDICAL ETHICS; MOTIVATION; NEOPLASM; PILOT STUDY; PROFESSIONAL PATIENT RELATIONSHIP; QUESTIONNAIRE; STATISTICS; UNITED STATES;

EMPIRICAL APPROACH; PROFESSIONAL PATIENT RELATIONSHIP;

CANCER CARE FACILITIES; CULTURAL CHARACTERISTICS; ETHICS, MEDICAL; ETHNIC GROUPS; HUMANS; MOTIVATION; NEOPLASMS; PHYSICIAN-PATIENT RELATIONS; PILOT PROJECTS; PROFESSIONAL-FAMILY RELATIONS; QUESTIONNAIRES; TEXAS; TRUTH DISCLOSURE;

EID: 0034264235     PISSN: 10467890     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (50)

1. D. Oken, "What to Tell Cancer Patients: A Study of Medical Attitudes," Journal of the American Medical Association 175 (1961): 1120-8.
2. D. Novack et al., "Changes in Physicians' Attitudes Toward Telling the Cancer Patient," Journal of the American Medical Association 241 (1979): 897-900.
3. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
4. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
5. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
6. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
7. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
8. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
9. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
10. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
11. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
12. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
13. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
14. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
15. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
16. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
17. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
18. Issues of two journals, The Journal of Clinical Ethics 9, no. 2 (summer 1998) and Annals of the New York Academy of Sciences 809 (20 February 1997), have been devoted to cross-cultural problems in communication and decision making. See also A. Surbone, "Truth Telling to the Patient," Journal of the American Medical Association 268 (1992): 1661-2; E. Pellegrino, "Is Truth Telling to the Patient a Cultural Artifact?" Journal of the American Medical Association 268 (1992): 1734-5; J. Muller and B. Desmond, "Ethical Dilemmas in a Cross-Cultural Context: A Chinese Example," Western Journal of Medicine 157 (1992): 323-7; B. Freedman, "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient," Archives of Internal Medicine 153 (1993): 572-6; P. Marshall, D. Thomasma, and J. Bergsma, "Intercultural Reasoning: The Challenge for International Bioethics," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 321-7; L. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (1995): 844-5; N. Jecker, J. Carrese, and R. Pearlman, "Caring for Patients in Cross-Cultural Settings," Hastings Center Report 25, no. 1 (1995): 6-14; B. Koenig and J. Gates-Williams, "Understanding Cultural Difference in Caring for Dying Patients," Western Journal of Medicine 163 (1995): 244-9; R. Orr, P. Marshall, and J. Osbura, "Cross-Cultural Considerations in Clinical Ethics Consultation," Archives of Family Medicine 4 (1995): 159-64; H.E. Hern et al., "The Difference That Culture Can Make in End-of-Life Decisionmaking," Cambridge Quarterly of Healthcare Ethics 7, no. 1 (1998): 27-40; R. Macklin, "Ethical Relativism in a Multicultural Society," Kennedy Institute of Ethics Journal 8, no. 1 (1998): 1-22. Regarding the role of the family, see J. Hardwig, "What About the Family?" Hastings Center Report 20, no. 2 (1990): 5-10; J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12; J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13.
19. L. Blackhall et al., "Ethnicity and Attitudes Toward Patient Autonomy," Journal of the American Medical Association 274 (1995): 820-5; J. Carrese and L. Rhodes, "Western Bioethics on the Navajo Reservation: Benefit or Harm?" Journal of the American Medical Association 274 (1995): 826-9; C. Orona, B. Koenig, and A. Davis, "Cultural Aspects of Nondisclosure," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 338-46.
20. L. Blackhall et al., "Ethnicity and Attitudes Toward Patient Autonomy," Journal of the American Medical Association 274 (1995): 820-5; J. Carrese and L. Rhodes, "Western Bioethics on the Navajo Reservation: Benefit or Harm?" Journal of the American Medical Association 274 (1995): 826-9; C. Orona, B. Koenig, and A. Davis, "Cultural Aspects of Nondisclosure," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 338-46.
21. L. Blackhall et al., "Ethnicity and Attitudes Toward Patient Autonomy," Journal of the American Medical Association 274 (1995): 820-5; J. Carrese and L. Rhodes, "Western Bioethics on the Navajo Reservation: Benefit or Harm?" Journal of the American Medical Association 274 (1995): 826-9; C. Orona, B. Koenig, and A. Davis, "Cultural Aspects of Nondisclosure," Cambridge Quarterly of Healthcare Ethics 3, no. 3 (1994): 338-46.
22. See, for example, J.C. Holland et al., "An International Survey of Physician Attitudes and Practice in Regard to Revealing the Diagnosis of Cancer," Cancer Investigation 5 (1987): 151-4; J. Estape et al., "Cancer Diagnosis Disclosure in a Spanish Hospital," Annals of Oncology 3 (1992): 451-4; O. Thomsen et al., "What Do Gastroenterologists in Europe Tell Cancer Patients?" Lancet 341 (1993): 473-6; L. Fallowfield, S. Ford, and S. Lewis, "No News Is Not Good News: Information Preferences of Patients with Cancer," Psycho-Oncology 4 (1995): 197-202; M.A. Annunziata et al., "Physicians and Death: Comments and Behaviour of 605 Doctors in the North-East of Italy," Supportive Care in Cancer 4 (1996): 334-40; A. Mobeireek et al., "Communication with the Seriously Ill: Physicians' Attitudes in Saudi Arabia," Journal of Medical Ethics 22 (1996): 282-5; D. Gordon and E. Paci, "Disclosure Practices and Cultural Narratives: Understanding Concealment and Silence around Cancer in Tuscany, Italy," Social Science & Medicine 44 (1997): 1433-52; A. Harrison et al., "Should Doctors Inform Terminally Ill Patients? The Opinions of Nationals and Doctors in the United Arab Emirates," Journal of Medical Ethics 23 (1997): 101-7; G. Rigatos, "Cancer and Truth-Telling in Greece," Annals of the New York Academy of Sciences 809 (1997): 382-92; L. Torrecillas, "Communication of the Cancer Diagnosis to Mexican Patients: Attitudes of Physicians and Patients," Annals of the New York Academy of Sciences 809 (1997): 188-96; T.S. Elwyn et al., "Cancer Disclosure in Japan: Historical Comparisons, Current Practices," Social Science & Medicine 46 (1998): 1151-63.
23. See, for example, J.C. Holland et al., "An International Survey of Physician Attitudes and Practice in Regard to Revealing the Diagnosis of Cancer," Cancer Investigation 5 (1987): 151-4; J. Estape et al., "Cancer Diagnosis Disclosure in a Spanish Hospital," Annals of Oncology 3 (1992): 451-4; O. Thomsen et al., "What Do Gastroenterologists in Europe Tell Cancer Patients?" Lancet 341 (1993): 473-6; L. Fallowfield, S. Ford, and S. Lewis, "No News Is Not Good News: Information Preferences of Patients with Cancer," Psycho-Oncology 4 (1995): 197-202; M.A. Annunziata et al., "Physicians and Death: Comments and Behaviour of 605 Doctors in the North-East of Italy," Supportive Care in Cancer 4 (1996): 334-40; A. Mobeireek et al., "Communication with the Seriously Ill: Physicians' Attitudes in Saudi Arabia," Journal of Medical Ethics 22 (1996): 282-5; D. Gordon and E. Paci, "Disclosure Practices and Cultural Narratives: Understanding Concealment and Silence around Cancer in Tuscany, Italy," Social Science & Medicine 44 (1997): 1433-52; A. Harrison et al., "Should Doctors Inform Terminally Ill Patients? The Opinions of Nationals and Doctors in the United Arab Emirates," Journal of Medical Ethics 23 (1997): 101-7; G. Rigatos, "Cancer and Truth-Telling in Greece," Annals of the New York Academy of Sciences 809 (1997): 382-92; L. Torrecillas, "Communication of the Cancer Diagnosis to Mexican Patients: Attitudes of Physicians and Patients," Annals of the New York Academy of Sciences 809 (1997): 188-96; T.S. Elwyn et al., "Cancer Disclosure in Japan: Historical Comparisons, Current Practices," Social Science & Medicine 46 (1998): 1151-63.
24. See, for example, J.C. Holland et al., "An International Survey of Physician Attitudes and Practice in Regard to Revealing the Diagnosis of Cancer," Cancer Investigation 5 (1987): 151-4; J. Estape et al., "Cancer Diagnosis Disclosure in a Spanish Hospital," Annals of Oncology 3 (1992): 451-4; O. Thomsen et al., "What Do Gastroenterologists in Europe Tell Cancer Patients?" Lancet 341 (1993): 473-6; L. Fallowfield, S. Ford, and S. Lewis, "No News Is Not Good News: Information Preferences of Patients with Cancer," Psycho-Oncology 4 (1995): 197-202; M.A. Annunziata et al., "Physicians and Death: Comments and Behaviour of 605 Doctors in the North-East of Italy," Supportive Care in Cancer 4 (1996): 334-40; A. Mobeireek et al., "Communication with the Seriously Ill: Physicians' Attitudes in Saudi Arabia," Journal of Medical Ethics 22 (1996): 282-5; D. Gordon and E. Paci, "Disclosure Practices and Cultural Narratives: Understanding Concealment and Silence around Cancer in Tuscany, Italy," Social Science & Medicine 44 (1997): 1433-52; A. Harrison et al., "Should Doctors Inform Terminally Ill Patients? The Opinions of Nationals and Doctors in the United Arab Emirates," Journal of Medical Ethics 23 (1997): 101-7; G. Rigatos, "Cancer and Truth-Telling in Greece," Annals of the New York Academy of Sciences 809 (1997): 382-92; L. Torrecillas, "Communication of the Cancer Diagnosis to Mexican Patients: Attitudes of Physicians and Patients," Annals of the New York Academy of Sciences 809 (1997): 188-96; T.S. Elwyn et al., "Cancer Disclosure in Japan: Historical Comparisons, Current Practices," Social Science & Medicine 46 (1998): 1151-63.
25. See, for example, J.C. Holland et al., "An International Survey of Physician Attitudes and Practice in Regard to Revealing the Diagnosis of Cancer," Cancer Investigation 5 (1987): 151-4; J. Estape et al., "Cancer Diagnosis Disclosure in a Spanish Hospital," Annals of Oncology 3 (1992): 451-4; O. Thomsen et al., "What Do Gastroenterologists in Europe Tell Cancer Patients?" Lancet 341 (1993): 473-6; L. Fallowfield, S. Ford, and S. Lewis, "No News Is Not Good News: Information Preferences of Patients with Cancer," Psycho-Oncology 4 (1995): 197-202; M.A. Annunziata et al., "Physicians and Death: Comments and Behaviour of 605 Doctors in the North-East of Italy," Supportive Care in Cancer 4 (1996): 334-40; A. Mobeireek et al., "Communication with the Seriously Ill: Physicians' Attitudes in Saudi Arabia," Journal of Medical Ethics 22 (1996): 282-5; D. Gordon and E. Paci, "Disclosure Practices and Cultural Narratives: Understanding Concealment and Silence around Cancer in Tuscany, Italy," Social Science & Medicine 44 (1997): 1433-52; A. Harrison et al., "Should Doctors Inform Terminally Ill Patients? The Opinions of Nationals and Doctors in the United Arab Emirates," Journal of Medical Ethics 23 (1997): 101-7; G. Rigatos, "Cancer and Truth-Telling in Greece," Annals of the New York Academy of Sciences 809 (1997): 382-92; L. Torrecillas, "Communication of the Cancer Diagnosis to Mexican Patients: Attitudes of Physicians and Patients," Annals of the New York Academy of Sciences 809 (1997): 188-96; T.S. Elwyn et al., "Cancer Disclosure in Japan: Historical Comparisons, Current Practices," Social Science & Medicine 46 (1998): 1151-63.
26. See, for example, J.C. Holland et al., "An International Survey of Physician Attitudes and Practice in Regard to Revealing the Diagnosis of Cancer," Cancer Investigation 5 (1987): 151-4; J. Estape et al., "Cancer Diagnosis Disclosure in a Spanish Hospital," Annals of Oncology 3 (1992): 451-4; O. Thomsen et al., "What Do Gastroenterologists in Europe Tell Cancer Patients?" Lancet 341 (1993): 473-6; L. Fallowfield, S. Ford, and S. Lewis, "No News Is Not Good News: Information Preferences of Patients with Cancer," Psycho-Oncology 4 (1995): 197-202; M.A. Annunziata et al., "Physicians and Death: Comments and Behaviour of 605 Doctors in the North-East of Italy," Supportive Care in Cancer 4 (1996): 334-40; A. Mobeireek et al., "Communication with the Seriously Ill: Physicians' Attitudes in Saudi Arabia," Journal of Medical Ethics 22 (1996): 282-5; D. Gordon and E. Paci, "Disclosure Practices and Cultural Narratives: Understanding Concealment and Silence around Cancer in Tuscany, Italy," Social Science & Medicine 44 (1997): 1433-52; A. Harrison et al., "Should Doctors Inform Terminally Ill Patients? The Opinions of Nationals and Doctors in the United Arab Emirates," Journal of Medical Ethics 23 (1997): 101-7; G. Rigatos, "Cancer and Truth-Telling in Greece," Annals of the New York Academy of Sciences 809 (1997): 382-92; L. Torrecillas, "Communication of the Cancer Diagnosis to Mexican Patients: Attitudes of Physicians and Patients," Annals of the New York Academy of Sciences 809 (1997): 188-96; T.S. Elwyn et al., "Cancer Disclosure in Japan: Historical Comparisons, Current Practices," Social Science & Medicine 46 (1998): 1151-63.
27. See, for example, J.C. Holland et al., "An International Survey of Physician Attitudes and Practice in Regard to Revealing the Diagnosis of Cancer," Cancer Investigation 5 (1987): 151-4; J. Estape et al., "Cancer Diagnosis Disclosure in a Spanish Hospital," Annals of Oncology 3 (1992): 451-4; O. Thomsen et al., "What Do Gastroenterologists in Europe Tell Cancer Patients?" Lancet 341 (1993): 473-6; L. Fallowfield, S. Ford, and S. Lewis, "No News Is Not Good News: Information Preferences of Patients with Cancer," Psycho-Oncology 4 (1995): 197-202; M.A. Annunziata et al., "Physicians and Death: Comments and Behaviour of 605 Doctors in the North-East of Italy," Supportive Care in Cancer 4 (1996): 334-40; A. Mobeireek et al., "Communication with the Seriously Ill: Physicians' Attitudes in Saudi Arabia," Journal of Medical Ethics 22 (1996): 282-5; D. Gordon and E. Paci, "Disclosure Practices and Cultural Narratives: Understanding Concealment and Silence around Cancer in Tuscany, Italy," Social Science & Medicine 44 (1997): 1433-52; A. Harrison et al., "Should Doctors Inform Terminally Ill Patients? The Opinions of Nationals and Doctors in the United Arab Emirates," Journal of Medical Ethics 23 (1997): 101-7; G. Rigatos, "Cancer and Truth-Telling in Greece," Annals of the New York Academy of Sciences 809 (1997): 382-92; L. Torrecillas, "Communication of the Cancer Diagnosis to Mexican Patients: Attitudes of Physicians and Patients," Annals of the New York Academy of Sciences 809 (1997): 188-96; T.S. Elwyn et al., "Cancer Disclosure in Japan: Historical Comparisons, Current Practices," Social Science & Medicine 46 (1998): 1151-63.
28. See, for example, J.C. Holland et al., "An International Survey of Physician Attitudes and Practice in Regard to Revealing the Diagnosis of Cancer," Cancer Investigation 5 (1987): 151-4; J. Estape et al., "Cancer Diagnosis Disclosure in a Spanish Hospital," Annals of Oncology 3 (1992): 451-4; O. Thomsen et al., "What Do Gastroenterologists in Europe Tell Cancer Patients?" Lancet 341 (1993): 473-6; L. Fallowfield, S. Ford, and S. Lewis, "No News Is Not Good News: Information Preferences of Patients with Cancer," Psycho-Oncology 4 (1995): 197-202; M.A. Annunziata et al., "Physicians and Death: Comments and Behaviour of 605 Doctors in the North-East of Italy," Supportive Care in Cancer 4 (1996): 334-40; A. Mobeireek et al., "Communication with the Seriously Ill: Physicians' Attitudes in Saudi Arabia," Journal of Medical Ethics 22 (1996): 282-5; D. Gordon and E. Paci, "Disclosure Practices and Cultural Narratives: Understanding Concealment and Silence around Cancer in Tuscany, Italy," Social Science & Medicine 44 (1997): 1433-52; A. Harrison et al., "Should Doctors Inform Terminally Ill Patients? The Opinions of Nationals and Doctors in the United Arab Emirates," Journal of Medical Ethics 23 (1997): 101-7; G. Rigatos, "Cancer and Truth-Telling in Greece," Annals of the New York Academy of Sciences 809 (1997): 382-92; L. Torrecillas, "Communication of the Cancer Diagnosis to Mexican Patients: Attitudes of Physicians and Patients," Annals of the New York Academy of Sciences 809 (1997): 188-96; T.S. Elwyn et al., "Cancer Disclosure in Japan: Historical Comparisons, Current Practices," Social Science & Medicine 46 (1998): 1151-63.
29. See, for example, J.C. Holland et al., "An International Survey of Physician Attitudes and Practice in Regard to Revealing the Diagnosis of Cancer," Cancer Investigation 5 (1987): 151-4; J. Estape et al., "Cancer Diagnosis Disclosure in a Spanish Hospital," Annals of Oncology 3 (1992): 451-4; O. Thomsen et al., "What Do Gastroenterologists in Europe Tell Cancer Patients?" Lancet 341 (1993): 473-6; L. Fallowfield, S. Ford, and S. Lewis, "No News Is Not Good News: Information Preferences of Patients with Cancer," Psycho-Oncology 4 (1995): 197-202; M.A. Annunziata et al., "Physicians and Death: Comments and Behaviour of 605 Doctors in the North-East of Italy," Supportive Care in Cancer 4 (1996): 334-40; A. Mobeireek et al., "Communication with the Seriously Ill: Physicians' Attitudes in Saudi Arabia," Journal of Medical Ethics 22 (1996): 282-5; D. Gordon and E. Paci, "Disclosure Practices and Cultural Narratives: Understanding Concealment and Silence around Cancer in Tuscany, Italy," Social Science & Medicine 44 (1997): 1433-52; A. Harrison et al., "Should Doctors Inform Terminally Ill Patients? The Opinions of Nationals and Doctors in the United Arab Emirates," Journal of Medical Ethics 23 (1997): 101-7; G. Rigatos, "Cancer and Truth-Telling in Greece," Annals of the New York Academy of Sciences 809 (1997): 382-92; L. Torrecillas, "Communication of the Cancer Diagnosis to Mexican Patients: Attitudes of Physicians and Patients," Annals of the New York Academy of Sciences 809 (1997): 188-96; T.S. Elwyn et al., "Cancer Disclosure in Japan: Historical Comparisons, Current Practices," Social Science & Medicine 46 (1998): 1151-63.
30. See, for example, J.C. Holland et al., "An International Survey of Physician Attitudes and Practice in Regard to Revealing the Diagnosis of Cancer," Cancer Investigation 5 (1987): 151-4; J. Estape et al., "Cancer Diagnosis Disclosure in a Spanish Hospital," Annals of Oncology 3 (1992): 451-4; O. Thomsen et al., "What Do Gastroenterologists in Europe Tell Cancer Patients?" Lancet 341 (1993): 473-6; L. Fallowfield, S. Ford, and S. Lewis, "No News Is Not Good News: Information Preferences of Patients with Cancer," Psycho-Oncology 4 (1995): 197-202; M.A. Annunziata et al., "Physicians and Death: Comments and Behaviour of 605 Doctors in the North-East of Italy," Supportive Care in Cancer 4 (1996): 334-40; A. Mobeireek et al., "Communication with the Seriously Ill: Physicians' Attitudes in Saudi Arabia," Journal of Medical Ethics 22 (1996): 282-5; D. Gordon and E. Paci, "Disclosure Practices and Cultural Narratives: Understanding Concealment and Silence around Cancer in Tuscany, Italy," Social Science & Medicine 44 (1997): 1433-52; A. Harrison et al., "Should Doctors Inform Terminally Ill Patients? The Opinions of Nationals and Doctors in the United Arab Emirates," Journal of Medical Ethics 23 (1997): 101-7; G. Rigatos, "Cancer and Truth-Telling in Greece," Annals of the New York Academy of Sciences 809 (1997): 382-92; L. Torrecillas, "Communication of the Cancer Diagnosis to Mexican Patients: Attitudes of Physicians and Patients," Annals of the New York Academy of Sciences 809 (1997): 188-96; T.S. Elwyn et al., "Cancer Disclosure in Japan: Historical Comparisons, Current Practices," Social Science & Medicine 46 (1998): 1151-63.
31. See, for example, J.C. Holland et al., "An International Survey of Physician Attitudes and Practice in Regard to Revealing the Diagnosis of Cancer," Cancer Investigation 5 (1987): 151-4; J. Estape et al., "Cancer Diagnosis Disclosure in a Spanish Hospital," Annals of Oncology 3 (1992): 451-4; O. Thomsen et al., "What Do Gastroenterologists in Europe Tell Cancer Patients?" Lancet 341 (1993): 473-6; L. Fallowfield, S. Ford, and S. Lewis, "No News Is Not Good News: Information Preferences of Patients with Cancer," Psycho-Oncology 4 (1995): 197-202; M.A. Annunziata et al., "Physicians and Death: Comments and Behaviour of 605 Doctors in the North-East of Italy," Supportive Care in Cancer 4 (1996): 334-40; A. Mobeireek et al., "Communication with the Seriously Ill: Physicians' Attitudes in Saudi Arabia," Journal of Medical Ethics 22 (1996): 282-5; D. Gordon and E. Paci, "Disclosure Practices and Cultural Narratives: Understanding Concealment and Silence around Cancer in Tuscany, Italy," Social Science & Medicine 44 (1997): 1433-52; A. Harrison et al., "Should Doctors Inform Terminally Ill Patients? The Opinions of Nationals and Doctors in the United Arab Emirates," Journal of Medical Ethics 23 (1997): 101-7; G. Rigatos, "Cancer and Truth-Telling in Greece," Annals of the New York Academy of Sciences 809 (1997): 382-92; L. Torrecillas, "Communication of the Cancer Diagnosis to Mexican Patients: Attitudes of Physicians and Patients," Annals of the New York Academy of Sciences 809 (1997): 188-96; T.S. Elwyn et al., "Cancer Disclosure in Japan: Historical Comparisons, Current Practices," Social Science & Medicine 46 (1998): 1151-63.
32. See, for example, J.C. Holland et al., "An International Survey of Physician Attitudes and Practice in Regard to Revealing the Diagnosis of Cancer," Cancer Investigation 5 (1987): 151-4; J. Estape et al., "Cancer Diagnosis Disclosure in a Spanish Hospital," Annals of Oncology 3 (1992): 451-4; O. Thomsen et al., "What Do Gastroenterologists in Europe Tell Cancer Patients?" Lancet 341 (1993): 473-6; L. Fallowfield, S. Ford, and S. Lewis, "No News Is Not Good News: Information Preferences of Patients with Cancer," Psycho-Oncology 4 (1995): 197-202; M.A. Annunziata et al., "Physicians and Death: Comments and Behaviour of 605 Doctors in the North-East of Italy," Supportive Care in Cancer 4 (1996): 334-40; A. Mobeireek et al., "Communication with the Seriously Ill: Physicians' Attitudes in Saudi Arabia," Journal of Medical Ethics 22 (1996): 282-5; D. Gordon and E. Paci, "Disclosure Practices and Cultural Narratives: Understanding Concealment and Silence around Cancer in Tuscany, Italy," Social Science & Medicine 44 (1997): 1433-52; A. Harrison et al., "Should Doctors Inform Terminally Ill Patients? The Opinions of Nationals and Doctors in the United Arab Emirates," Journal of Medical Ethics 23 (1997): 101-7; G. Rigatos, "Cancer and Truth-Telling in Greece," Annals of the New York Academy of Sciences 809 (1997): 382-92; L. Torrecillas, "Communication of the Cancer Diagnosis to Mexican Patients: Attitudes of Physicians and Patients," Annals of the New York Academy of Sciences 809 (1997): 188-96; T.S. Elwyn et al., "Cancer Disclosure in Japan: Historical Comparisons, Current Practices," Social Science & Medicine 46 (1998): 1151-63.
33. Muller and Desmond; Freedman; Koenig and Gates-Williams; Orr, Marshall, and Osbum; and Macklin, see note 3 above. Orona, Koenig, and Davis, see note 4 above. G.L. Brotzman and D.J. Butler, "Cross-Cultural Issues in the Disclosure of a Terminal 'Diagnosis" Journal of Family Practice 32 (1991): 426-7; M.D. Fetters, "The Family in Medical Decision Making: Japanese Perspectives," The Journal of Clinical Ethics 9, no. 2 (1998): 132-46.
34. Muller and Desmond; Freedman; Koenig and Gates-Williams; Orr, Marshall, and Osbum; and Macklin, see note 3 above. Orona, Koenig, and Davis, see note 4 above. G.L. Brotzman and D.J. Butler, "Cross-Cultural Issues in the Disclosure of a Terminal 'Diagnosis" Journal of Family Practice 32 (1991): 426-7; M.D. Fetters, "The Family in Medical Decision Making: Japanese Perspectives," The Journal of Clinical Ethics 9, no. 2 (1998): 132-46.
35. Orona, Koenig, and Davis, see note 4 above; Holland et al., see note 5 above.
36. M.D. Good et al., "American Oncology and the Discourse of Hope," Culture, Medicine and Psychiatry 14 (1990): 59-79; M.V. Burton and R.W. Parker, "Psychological Aspects of Cancer Surgery: Surgeons' Attitudes," Psycho-Oncology 6 (1997): 47-64.
37. M.D. Good et al., "American Oncology and the Discourse of Hope," Culture, Medicine and Psychiatry 14 (1990): 59-79; M.V. Burton and R.W. Parker, "Psychological Aspects of Cancer Surgery: Surgeons' Attitudes," Psycho-Oncology 6 (1997): 47-64.
38. E. Kodish and S. Post, "Oncology and Hope," Journal of Clinical Oncology 13 (1995): 1817-22.
39. There are at least two kinds of information subsumed under the category of prognosis: (1) information about whether the disease is curable, and (2) survival estimates. In the individual case, oncologists appear to be much more accurate in relation to (1) than (2). W.J. Mackillop and C.F. Quirt, "Measuring the Accuracy of Prognostic Judgments in Oncology" Journal of Clinical Epidemiology 50 (1997): 21-9.
40. In a 1982 survey of 1,250 adults, 85 percent of respondents said they would want their physician to give them a realistic estimate of how long they had to live, supposing they had a type of cancer that usually leads to death in less than a year. Respondents who were in poor health, were aged 65 and over, had not graduated from high school, and were in the lower-income categories reported that they were less likely to want a realistic estimate than respondents in other groups. See President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, Making Health Care Decisions (Washington, D.C.: U.S. Government Printing Office, 1982), 2: appendixes . In two small-scale studies in the United States and Britain, the majority of cancer patients-for whom these matters are less hypothetical-wanted as much information as possible, whether good or bad. Advanced age and poor prognosis were associated with a diminished desire for information. B.R.
41. In a 1982 survey of 1,250 adults, 85 percent of respondents said they would want their physician to give them a realistic estimate of how long they had to live, supposing they had a type of cancer that usually leads to death in less than a year. Respondents who were in poor health, were aged 65 and over, had not graduated from high school, and were in the lower-income categories reported that they were less likely to want a realistic estimate than respondents in other groups. See President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, Making Health Care Decisions (Washington, D.C.: U.S. Government Printing Office, 1982), 2: appendixes . In two small-scale studies in the United States and Britain, the majority of cancer patients-for whom these matters are less hypothetical-wanted as much information as possible, whether good or bad. Advanced age and poor prognosis were associated with a diminished desire for information. B.R. Cassileth, "Information and Participation Preferences among Cancer Patients," Annals of Internal Medicine 92 (1980): 832-6; Fallowfield, Ford, and Lewis, see note 5 above. A 1995 survey of 200 individuals over the age of 65 focused on differences among ethnic groups. The question concerning disclosure of prognosis was framed in the third person: "The patient will probably die of the cancer. Should the physician tell the patient that he or she will probably die?" The majority of African-American and European-American respondents said yes, while the majority of Korean-American and Mexican-American respondents said no. Blackball et al., see note 4 above. People may respond differently to questions about what should happen in general versus what they would want in their own case. In 1997 survey, investigators found that 30 percent of respondents said a physician who knows a patient has a 50 percent chance of dying within the next six months should inform the patient, while 57 percent said they would want the physician to tell them if they only had a short time to live. Harrison et al., see note 5 above.
42. See J.C. Weeks et al., "Relationship between Cancer Patients' Predictions of Prognosis and Their Treatment Preferences," Journal of the American Medical Association 279 (1998): 1709-14; T.J. Smith and K. Swisher, "Telling the Truth about Terminal Cancer," Journal of the American Medical Association 279 (1998): 17 M.F. Costantini-Ferrando, K.M. Foley, and B.D. Rapkin, "Communicating with Patients about Advanced Cancer," Journal of the American Medical Association 280 (1998): 1403.
43. See J.C. Weeks et al., "Relationship between Cancer Patients' Predictions of Prognosis and Their Treatment Preferences," Journal of the American Medical Association 279 (1998): 1709-14; T.J. Smith and K. Swisher, "Telling the Truth about Terminal Cancer," Journal of the American Medical Association 279 (1998): 17 M.F. Costantini-Ferrando, K.M. Foley, and B.D. Rapkin, "Communicating with Patients about Advanced Cancer," Journal of the American Medical Association 280 (1998): 1403.
44. See J.C. Weeks et al., "Relationship between Cancer Patients' Predictions of Prognosis and Their Treatment Preferences," Journal of the American Medical Association 279 (1998): 1709-14; T.J. Smith and K. Swisher, "Telling the Truth about Terminal Cancer," Journal of the American Medical Association 279 (1998): 17 M.F. Costantini-Ferrando, K.M. Foley, and B.D. Rapkin, "Communicating with Patients about Advanced Cancer," Journal of the American Medical Association 280 (1998): 1403.
45. The categories employed by the Medical Informatics Department to profile patients are not identical to the categories employed in this study, but some rough analogues are available. Of a total of 18,714 new patients for the fiscal year 1995-1996,13,203 (71 percent) were classified as Anglo, 1,422 (8 percent) were classified as Black, and 1,782 (10 percent) were classified as "Spanish surname." Unfortunately, the category of Anglo includes the vast majority of patients that might be identified as Arab or Middle Eastern. A breakdown of patients from outside the United States (1,121 or 6 percent of all new patients) by country reveals that 273 patients came from Bahrain, Egypt, Iran, Israel Jordan, Kuwait, Lebanon, Qatar, Saudi Arabia, Syria, Turkey, and the United Arab Emirates. For purposes of comparison, 612 patients came from Central and Latin America, Spain, and Portugal, and 56 patients came from the Pacific Islands and countries in Asia.
46. Freedman; Hern et al.; and Macklin, see note 3 above.
47. This may or may not be accurate as a statement of current law. Concerning diagnosis, the patient clearly has a legal right to be informed, but several commentators suggest that the patient may waive this right. See A. Meisel and M. Kuczewski, "Legal and Ethical Myths about Informed Consent," Archives of Internal Medicine 156 (1996): 2521-6. Disclosure requirements in the area of prognosis are more unsettled. See G. Annas, "Informed Consent, Cancer, and Truth in Prognosis," New England Journal of Medicine 330 (1994): 223-5.
48. This may or may not be accurate as a statement of current law. Concerning diagnosis, the patient clearly has a legal right to be informed, but several commentators suggest that the patient may waive this right. See A. Meisel and M. Kuczewski, "Legal and Ethical Myths about Informed Consent," Archives of Internal Medicine 156 (1996): 2521-6. Disclosure requirements in the area of prognosis are more unsettled. See G. Annas, "Informed Consent, Cancer, and Truth in Prognosis," New England Journal of Medicine 330 (1994): 223-5.
49. R. Cooper and R. David, "The Biological Concept of Race and Its Application to Health and Epidemiology," Journal of Health Politics, Policy, and Law 11 (1986): 97-116
50. E. Blacksher, "Desperately Seeking Difference," Cambridge Quarterly of Healthcare Ethics?, no. 1 (1998): 11-6.