Japanese nurses’ perceptions about disclosure of information at the patients’ end of life

Abstract

Information disclosure at the end of life is one of the most debated ethical issues in Japan. This paper, using data from a larger questionnaire survey in which 147 Japanese nurses participated, describes nurses' perceptions about this issue. The nurses perceived that non-disclosure of impending death information to patients was the norm in Japan due to its traditional values. This non-disclosure of information has various impacts on clinical nurses. Tension was evident between the Japanese traditional concepts supported by some nurses and the shift toward Western cultural and ethical values supported by other nurses. The nurses confronted uninformed patients who became suspicious, isolated, angry, or died unprepared for their life's ending. The nurses were placed in the middle between the patient and the family, as nurses became keepers of family secrets, or between nurses' ethical obligations to the patient and those of the institution. The nurses had the belief that at the patient's end of life, it is important to change health professionals' attitude from curing to caring.

Voluntary Active Euthanasia and the Nurse: a comparison of Japanese and Australian nurses

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Deception, Catholicism, and Hope: Understanding Problems in the Communication of Unfavorable Prognoses in Traditionally-Catholic Countries

“…Research has shown that different ethnicities and cultures have different attitudes towards the communication of diagnosis and prognosis to terminally ill patients (Blackhall et al 1995;Frank et al 1998;Huang et al 1999;Konishi and Davis 1999). In the USA, for instance, various ethnic American (including Korean-, Chinese-, Mexican-, Hispanic-, African-, and European-American; Mitchell 1998) cancer patients and physicians consider complete and accurate disclosure of cancer undesirable (Hofmann et al 1997).…”

Racial/Ethnic Minority Access to End-of-Life Care: A Conceptual Framework

“…Compared to African American and White elderly patients, half as many Korean Americans and Mexican Americans report wanting to be told the truth about their diagnosis, with Korean Americans and Mexican Americans preferring the family, not the patient, to be the key decisionmaker concerning EOL choices (Blackhall et al, 1999;Blackhall, Murphy, Frank, Michel, & Azen, 1995). Additionally, studies have reported preferences against patient truth-telling among seriously ill Japanese (Ito, Tanida, & Turale, 2010;Konishi & Davis, 1999), Korean (Mo et al, 2011), and to a lesser extent Chinese patients (Fielding, Wong, & Ko, 1998;Jiang et al, 2007;Orona, Koenig, & Davis, 1994). As a result, the families of these patients often become the default care decision-makers as well (Hancock et al, 2007).…”