Respecting the autonomy of cancer patients when talking with their families: qualitative analysis of semistructured interviews with patients.
OBJECTIVE
To discover cancer patients' views about disclosure of information to their family, their family's influence over the information given them, and their preferences for doctors' behaviour if they and their family disagree, as a complement to applied ethical theory.


METHODS
Semistructured interviews followed by qualitative content analysis.


METHODS
Mainly urban British general practice.


METHODS
30 patients in whom cancer, excluding basal and squamous cell skin carcinomas, was diagnosed 1-7 years earlier.


RESULTS
All subjects wished doctors to respect their views rather than those of their family, should they differ. With their consent, subjects favoured close family receiving information about their illness, all but one mentioning advantage to their family. Without such consent, six unconditionally favoured disclosure of information to their family while seven unconditionally opposed disclosure. Seventeen participants restricted their approval for such disclosure to specific circumstances. Only two participants approved of their family influencing the information that they received about their illness; all but seven wished to receive full information, the exceptions relating to information about bad prognosis.


CONCLUSIONS
Subjects favoured openness with their family but most rejected unconditional disclosure of information without their consent and their family influencing what information they would be given. They valued respect for their autonomy more highly than beneficence and considered that their own needs took priority over those of their family.
Benson
J
J
Department of General Practice, United Medical and Dental School of Guy's Hospital, London.
Britten
N
N
D001294:Attitude to Health; D030881:Disclosure; D005192:Family Health; D005194:Family Practice; D006801:Humans; D007258:Informed Consent; D007407:Interviews as Topic; D009369:Neoplasms / Q000523:psychology*; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D036301:Qualitative Research; D012106:Research; D014342:Truth Disclosure; D014504:Urban Health