Disclosure of prognosis to terminally ill patients: attitudes and practices among French physicians.
BACKGROUND
Disclosure of the prognosis to terminally ill patients is a strong prerequisite for integrating the physical, psychological, spiritual, and social aspects of end-of-life care.


OBJECTIVE
This study aimed to assess French physicians' general attitudes and effective practices (with patients followed up to death recently) toward such disclosure.


METHODS
We used data from a cross-sectional survey conducted among a national sample of 917 French general practitioners, oncologists, and neurologists.


RESULTS
A majority of respondents opted for prognosis disclosure only at patients' request, very few opted for systematic disclosure without patient's request, and a significant minority opted for systematic concealment. Concerning deceased patients described by respondents, 44.5% of competent patients were informed of prognosis by their physician, 27.3% were informed by someone else, 9.0% refused to be informed, and 19.2% were simply not informed. Concealment was more frequent for older patients, and physicians involved in a nongovernmental organization (NGO) for patients' support were more likely to disclose the prognosis, even without patient's request.


CONCLUSIONS
Disclosure of the prognosis to terminally ill patients is still far from systematic in France. Further research is needed to better understand the motivations of French physicians' disclosure practices, which are probably culturally shaped.
Peretti-Watel
P
P
Regional Center for Disease Control of South-Eastern France, 23 rue Stanislas Torrents, 13006 Marseille, France. peretti@marseille.inserm.fr
Bendiane
M K
MK
Obadia
Y
Y
Lapiana
J M
JM
Galinier
A
A
Pegliasco
H
H
Favre
R
R
Moatti
J P
JP
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D004812:Epidemiologic Methods; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009462:Neurology; D009938:Organizations; D011379:Prognosis; D012737:Sex Factors; D019452:Terminally Ill / Q000523:psychology*; D014342:Truth Disclosure