rss
J Med Ethics 2007;33:67-70 doi:10.1136/jme.2005.014936
  • Clinical ethics

Doctor’s views on disclosing or withholding information on low risks of complication

  1. G G Palmboom1,
  2. D L Willems1,
  3. N B A T Janssen2,
  4. J C J M de Haes2
  1. 1Department of General Practice, Academic Medical Center, Amsterdam, The Netherlands
  2. 2Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands
  1. Correspondence to:
 D L Willems
 Academic Medical Center, University of Amsterdam, J2 119, PO Box 22700, 1100 DE Amsterdam, The Netherlands;d.l.willems{at}amc.uva.nl
  • Received 2 November 2005
  • Accepted 20 March 2006
  • Revised 17 March 2006

Abstract

Background: More and more quantitative information is becoming available about the risks of complications arising from medical treatment. In everyday practice, this raises the question whether each and every risk, however low, should be disclosed to patients. What could be good reasons for doing or not doing so? This will increasingly become a dilemma for practitioners.

Objective: To report doctors’ views on whether to disclose or withhold information on low risks of complications.

Methods: In a qualitative study design, 37 respondents (gastroenterologists and gynaecologists or obstetricians) were included. Focus group interviews were held with 22 respondents and individual in-depth interviews with 15.

Results: Doctors have doubts about disclosing or withholding information on complication risk, especially in a risk range of 1 in 200 to 1 in 10 000. Their considerations on whether to disclose or to withhold information depend on a complicated mix of patient and doctor-associated reasons; on medical and personal considerations; and on the kind and purpose of intervention.

Discussion: Even though the degree of a risk is important in a doctor’s considerations, the severity of the possible complications and patients’ wishes and competencies have an important role as well. Respondents said that low risks should always be communicated when there are alternatives for the intervention or when the patient may prevent or mitigate the risk. When the appropriateness of disclosing risks is doubtful, doctors should always tell their patients that no intervention is without risk, give them the opportunity to gather all the information they need or want, and enable them to detect a complication at an early stage.

Footnotes

  • Funding: Netherlands Organisation for Scientific Research.

  • Competing interests: None.

  • Equipment: MAXqda.

  • Ethical approval: Research ethics committee approval to conduct this study was not demanded because it did not fall within the remit of the Dutch Medical Research Involving Human Subjects Act (WMO).19

This Article

  1. Abstract
  2. Full text
  3. PDF

Responses

  1. Submit a response
  2. No responses published

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.