title: When clinicians telling the truth is de facto discouraged, what is the family's attitude towards disclosing to a relative their cancer diagnosis?
abstract: OBJECTIVE
  This study evaluated the attitudes of cancer patients' family members regarding disclosure of a cancer diagnosis to the patient and justifications for their attitudes.
  
  
  METHODS
  Family members were invited to complete a questionnaire to evaluate their attitudes towards disclosure of a cancer diagnosis to a relative as well as reasons for their point of view. Data were analyzed to evaluate factors influencing attitudes.
  
  
  RESULTS
  One hundred eighty-six completed surveys were returned. Of them, 44.1 % (82/186) indicated that the patient should be informed of the diagnosis, and 55.9 % (104/186) stated emphatically that the patient should not be told the truth. The main reason given for concealing the truth was fear that awareness of a cancer diagnosis might cause psychological morbidity. The justifications for disclosing the bad news were as follows: (1) obtaining the patient's cooperation during treatment, (2) the impossibility of concealment, and (3) believing the patient was psychologically strong enough to accept the truth. Patients' educational status and awareness of disease as well as family members' age were the factors that influenced attitudes toward disclosure.
  
  
  CONCLUSIONS
  Telling the truth to a cancer patient is often de facto discouraged in clinicians. Family members often support nondisclosure, especially when they have experience with a relative who is unaware of the truth. The education level of family members does not appear to influence decisions regarding disclosure. These findings can be helpful in the development of policies and/or programs to assist medical professionals and family members engage in truthful disclosure to a patient who has cancer.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 South Zhongguancun Avenue, Haidian District, Beijing, 100081, People's Republic of China.
authors.forename: Dian-can
authors.initials: DC
authors.lastname: Wang
authors.forename: Xin
authors.initials: X
authors.lastname: Peng
authors.forename: Chuan-bin
authors.initials: CB
authors.lastname: Guo
authors.forename: Yan-jie
authors.initials: YJ
authors.lastname: Su
mesh_terms: D000293:Adolescent; D000328:Adult; D001290:Attitude; D002681:China; D004522:Educational Status; D005190:Family / Q000523:psychology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D020458:Third-Party Consent; D014342:Truth Disclosure; D055815:Young Adult