title: Truth Telling as an Element of Culturally Competent Care at End of Life.
abstract: Nondisclosure of terminal prognosis in the context of intercultural interactions can cause moral distress among health care providers guided exclusively by informed consent. However, cultural humility can show that revealing and withholding prognostic information are two equally valid paths to the goal of protecting the patient from harm.
  
  
  
  Assumptions and history giving rise to the preference for truth telling in the United States(US) are examined. Principles of biomedical ethics are described within the context of US, Chinese, and Latin American cultures. The process of cultural competence in the delivery of health care services is explained and introduces the concept of cultural humility.
  
  
  
  By focusing more on biases and assumptions brought forth from the dominant culture, health care providers may experience less moral distress and convey increased caring in the context of intercultural interactions and nondisclosure of prognosis of a terminal illness.
authors.affiliation: Oregon Health & Science University School of Nursing, Portland, OR, USA risingm@ohsu.edu.
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Rising
mesh_terms: D001293:Attitude to Death / Q000208:ethnology*; D065246:Culturally Competent Care / Q000379:methods*; D006801:Humans; D007258:Informed Consent / Q000941:ethics* / Q000523:psychology / Q000592:standards; D013727:Terminal Care / Q000941:ethics / Q000523:psychology* / Q000592:standards; D016746:Transcultural Nursing / Q000379:methods; D014342:Truth Disclosure / Q000941:ethics*; D014481:United States / Q000208:ethnology
keywords: end-of-life care; nursing practice; transcultural health