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关于癌症诊断和预后的信息披露偏好:告知还是不告知?

Disclosure preferences regarding cancer diagnosis and prognosis: to tell or not to tell?

作者信息

Miyata H, Takahashi M, Saito T, Tachimori H, Kai I

机构信息

Department of Social Gerontology, University of Tokyo, Japan.

出版信息

J Med Ethics. 2005 Aug;31(8):447-51. doi: 10.1136/jme.2003.007302.

Abstract

Telling people that they have cancer has a great impact on their lives, so many doctors are concerned about how they should inform patients about a cancer diagnosis and its prognosis. We conducted a general population survey in Japan to investigate people's preferences on receiving this information. There were no significant differences in respondents' preferences according to the seriousness of the cancer. Full disclosure of the diagnosis was preferred by 86.1% of the respondents, while 2.7% wanted non-disclosure. As for the initial provision of information, the majority preferred partial disclosure concerning the prospects of complete recovery (64.5%) and the expected length of survival (64.1%). Those who responded negatively to the statement, "If I am close to the end of my life, I want to be informed of the fact so I can choose my own way of life", were more likely to want non-disclosure on diagnosis. The results suggest that, at the first opportunity of providing information, a disclosure policy of giving patients full details of their diagnosis and some information on prognosis can satisfy the preferences of most patients. Contrary to popular belief, the seriousness of the cancer and people's demographic characteristics displayed little impact in this study.

摘要

告知人们他们患有癌症会对其生活产生重大影响,因此许多医生担心应如何向患者告知癌症诊断结果及其预后情况。我们在日本进行了一项普通人群调查,以探究人们在接收此类信息方面的偏好。根据癌症的严重程度,受访者的偏好并无显著差异。86.1%的受访者倾向于完全披露诊断结果,而2.7%的人希望不披露。至于信息的初步提供,大多数人倾向于部分披露关于完全康复的前景(64.5%)和预期生存时长(64.1%)。那些对“如果我接近生命尽头,我希望被告知这一事实,以便我能选择自己的生活方式”这一说法持否定态度的人,更有可能希望不披露诊断结果。结果表明,在首次提供信息时,向患者全面详细地披露诊断结果以及一些预后信息的披露政策能够满足大多数患者的偏好。与普遍看法相反,在本研究中,癌症的严重程度和人们的人口统计学特征几乎没有影响。

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