"Don't tell her she's on hospice": ethics and pastoral care for families who withhold medical information.

When family members enroll a patient in hospice, they sometimes request that the patient not be told of the diagnosis and their enrollment in hospice--usually so the patient won't be sad. In these situations, hospice staff face an ethical dilemma involving a patient's right to full disclosure. A discussion of this issue at an ethics committee session, chaired by the author of this article, brought to light many personal dynamics associated with these situations, and the discussion is used by the author to draw conclusions about pastoral care for these patients and families. Several responses from colleagues follow.