Truth-Telling in Clinical Practice and the Arguments for and Against: a review of the literature

Abstract

In general, most, but not necessarily all, patients want truthfulness about their health. Available evidence indicates that truth-telling practices and preferences are, to an extent, a cultural artefact. It is the case that practices among nurses and doctors have moved towards more honest and truthful disclosure to their patients. It is interesting that arguments both for and against truth-telling are established in terms of autonomy and physical and psychological harm. In the literature reviewed here, there is also the view that truth-telling is essential because it is an intrinsic good, while it is argued against on the grounds of the uncertainty principle. Based on this review, it is recommended that practitioners ought to ask patients and patients' families what informational requirements are preferred, and research should continue into truth-telling in clinical practice, particularly to discover its very nature as a cultural artefact, and the other conditions and contexts in which truth-telling may not be preferred.

Existential encounters: Nurses' descriptions of critical incidents in end-of-life cancer care

“…This strategy makes nurses feel uncomfortable in their relationship with the patient leading to avoidance behavior as well as feelings of powerlessness and frustration with the family and medical colleagues (Costello, 2000;Georges and Grypdonck, 2002). To our knowledge the research about family withholding the truth from patients is scarce, but Tuckett (2004) suggests that health professionals must ask patients and families what information they prefer to know.…”

Not Just “Getting by”: Factors Influencing Providers’ Choice of Interpreters

“…From this perspective, clinical complexity also includes difficulties in providing culturally-sensitive care as certain topics (e.g., death and dying) often are infused with cultural values, resulting in diverse communicative practices in different communities. 31,32 Clinical Urgency. Different from the impacts of clinical complexity, where providers make educated decisions for their best option in a given context, clinical urgency leaves providers few choices in deciding the type of interpreters they would work with.…”

The meaning of nursing-home: ‘Waiting to go up to St. Peter, OK! Waiting house, sad but true’ — An Australian perspective

“…The reader is directed elsewhere for a more extensive analysis of themes from the literature as they relate to truth-telling in clinical practice (Tuckett, 2004a); ethical practice and the nature of the nursing-home in the Australian context (Tuckett, 2005a); and care, communication and control in the context of agedcare provision (Tuckett, 2005b). In this article, the literature reviewed is only that relevant to those themes expressed in the forthcoming data.…”