RT Journal Article
SR Electronic
T1 Family consent, communication, and advance directives for cancer disclosure: a Japanese case and discussion.
JF Journal of Medical Ethics
JO J Med Ethics
FD BMJ Publishing Group Ltd and Institute of Medical Ethics
SP 296
OP 301
DO 10.1136/jme.25.4.296
VO 25
IS 4
A1 Akabayashi, A
A1 Fetters, M D
A1 Elwyn, T S
YR 1999
UL http://jme.bmj.com/content/25/4/296.abstract
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.