Many Western doctors believe it is best to give full disclosure to patients regarding the diagnosis, treatment options and potential outcomes of severe or life threatening illnesses. This is considered the patient’s right to autonomy.

While patient autonomy is held in high regard in the US, for many other cultures including Arab, Asian, Latin American, as well as parts of Eastern and Southern Europe, disclosing an illness is undesirable. It is seen as a burden to the patient while withholding information gives peace and hope.

Many non-western cultures believe the illness is a shared responsibility of the family. They may prefer that the family receive information regarding diagnosis, as well as make decisions about and organize patient care. The family may ask that the patient not be told of the diagnosis.

Patients and providers will work best together when the relationship is based on trust and respect. For this reasons, physicians must consider the cultural beliefs and desires of their diverse patients regarding illness and treatment.

Physicians should find out the preferences for disclosure at the time of intake, before any testing is done, to avoid appearing as if they are hiding information they already know.  Physicians should find out:

  1. How does the patient/family view illness? Is it purely biomedical (Western) or more spiritual and holistic?
  2. Does the patient/family value individual decision-making  or collective family decision-making?
  3. Does the patient want to be told about the diagnosis, treatment options and possible outcomes? If so, in how much detail? If not, who should be told? Who will be responsible for decision making?

Physicians should show respect by incorporating the cultural values and beliefs  of patients and families into the decision-making process, even if it is in contrast to the physician’s own beliefs.