PT - JOURNAL ARTICLE AU - A Akabayashi AU - M D Fetters AU - T S Elwyn TI - Family consent, communication, and advance directives for cancer disclosure: a Japanese case and discussion. AID - 10.1136/jme.25.4.296 DP - 1999 Aug 01 TA - Journal of Medical Ethics PG - 296--301 VI - 25 IP - 4 4099 - http://jme.bmj.com/content/25/4/296.short 4100 - http://jme.bmj.com/content/25/4/296.full SO - J Med Ethics1999 Aug 01; 25 AB - The dilemma of whether and how to disclose a diagnosis of cancer or of any other terminal illness continues to be a subject of worldwide interest. We present the case of a 62-year-old Japanese woman afflicted with advanced gall bladder cancer who had previously expressed a preference not to be told a diagnosis of cancer. The treating physician revealed the diagnosis to the family first, and then told the patient: "You don't have any cancer yet, but if we don't treat you, it will progress to a cancer". In our analysis, we examine the role of family consent, communication patterns (including ambiguous disclosure), and advance directives for cancer disclosure in Japan. Finally, we explore the implications for Edmund Pellegrino's proposal of "something close to autonomy" as a universal good.