Showing 9 results for Truth
Mojtaba Parsa, Alireza Bagheri, Bagher Larijani,
Volume 4, Issue 6 (12-2011)
Abstract
Breaking bad news to the patients does not back to a long history and is a controversial issue between patients and physicians. Many physicians are reluctant to breaking bad news to patients and this is not desirable for most patients. For example, in Northern European countries and United States, most physicians usually break bad news to the patients, while in Southern and Eastern European countries or many Asian countries they would not do so. In Iran, physicians prefer to break bad news to patient's family rather than the patient. Cultural differences also influence people's viewpoints about breaking bad news. In Western countries, most people agree with breaking bad news to patients while it is not common in the other populations. Nowadays, the dominant view in the most countries is that it is the duty of the physicians to break bad news to patients. Some advantages of breaking bad news to patients including strengthening the trust between physician and patient, preventing non - maleficience, increasing patients satisfaction and reducing legal action against the doctors. There are some exceptions to breaking bad news the most important is serious psychological damage to the patient. Quality and quantity of information that should be released depends on situation of each patient. Breaking bad news needs specific communication skills and physicians must be trained for this purpose.
Hossein Atrak, Maryam Mollabakhshi,
Volume 5, Issue 4 (7-2012)
Abstract
Telling the truth to patients is a key issue in medical ethics. Today, most physicians hold that truth-telling to patients is crucial, and that lying to patients or withholding information from them is not acceptable. It seems, however, that absolute and unconditional truth-telling is not always possible, and it may not be feasible to tell some patients certain truths under some circumstances. Although truth-telling is a rudimentary principle in ethics, it is allowed to withhold truth or even to tell lies in some circumstances. From the point of view of reason and tradition, lying under certain circumstances is allowed for instance when one is disinclined to tell the truth, or in emergencies where truth-telling might lead to loss of life, property or someone's reputation, and when truth may involve two adequately unpleasant situations. In my opinion, it is necessary to tell the truth, regardless of possible harms, when continuation of treatment, or the patient's cooperation and consent depend on it, and also when the truth which needs to be told to a patient is the incurability of his disease and therefore his inevitable death,. In other cases, however, when there are truths such as severity of disease, death of others in the accident, family problems outside the hospital, predicted survival time, and other possible diagnoses, the truth can be withheld and the patient can even be lied to if there is any risk of harm to the patient.
Ahmad Ezadi, Esmaeil Mohammadnejad, Seyedeh Roghayeh Ehsani,
Volume 6, Issue 1 (4-2013)
Abstract
Truth telling is relaying the appropriate information to patients so that they can make informed decisions about their care and treatment. Truth encompasses all aspects of personal health. Due to inadequacy of research on the subject, the present study was conducted aiming to examine the phenomenology of truth telling based on nurses’ experiences.
A phenomenological qualitative approach was used in the year 2011-12 in a teaching hospital in Tehran. A sample of nurses was chosen based on the purposeful sampling method. Sample size was dependent on the data saturation with a total of 14 participants at the end. Data gathering was done using deep interviews, and the data was later analyzed through Celasi method.
Findings based on the nurses’ experiences of truth telling were extracted in 12 sub concepts and two main themes of reinforcing factors and obstacles to truth telling. According to these findings, nurses need to be informed of the patients’ conditions and be familiar with the appropriate methods and techniques for communication and transmission of bad news to patients in order to provide the best care, and this contributes to improvement of the performance of nurses.
Sayyed Esmaeil Managheb, Masoumeh Hosseinpour, Fatemeh Mehrabi,
Volume 6, Issue 4 (10-2013)
Abstract
Breaking bad news is an unavoidable part of the medical profession, and doctors and patients stand at the two sides of this function. There are different views about how to break bad news in different cultures and societies. In this study we assessed the viewpoints of hospitalized patients on how to break bad news.
This cross sectional study was performed in 2011 at the Jahrom University of Medical Sciences. Sample size of 110 patients was calculated and the method of sampling was simple random sampling. Target population was the hospitalized patients of Peymanyeh and Motahari hospitals in Jahrom. Entry criteria consisted of being admitted to the above hospitals, and exclusion criteria included severely ill patients and patients with mental disorders. A reliable self-administered questionnaire was designed and validated. The questionnaires were completed and returned by 110 patients. Data were analyzed using the SPSS16 software through descriptive analysis. One hundred and ten patients were included in this study. The factor analysis showed three elements: methods of breaking bad news, the people involved in the breaking bad news process, and timing and location. Of participants 78% wanted to be told the bad news while their relatives were present, 63.2% wanted to be told the bad news in a private and quiet room. Almost all respondents emphasized the need for religious advisors and psychological counselors (77.2% and 62.5% respectively). Most of participants (91.5%) wished to receive all the information about the etiology of their disease, and 74.8% of them wanted to be told whether their illness was cancer.This study showed that there are different views on how to break bad news in different cultures and societies. Social and cultural differences must be considered in breaking bad news. In our country, patients’ families could have a prominent supporting role in the delivery of bad news to patients.
Ali Labaf, Amirhossein Jahanshir, Amir Amir Shahvaraninasab,
Volume 7, Issue 1 (5-2014)
Abstract
Breaking bad news is one of the most difficult tasks an emergency physician has to perform and unfortunately it is not well studied. Almost all of the original studies for compilation of the guidelines of breaking bad news have been conducted in a non-emergent situation and were physician-oriented. In this study and by reviewing related articles in medical databases, the authors try to show the necessity of adapting these guidelines into the situation of the emergency departments and indigenizing them for non-Western countries. This can be the first step to design a guideline for the emergency department.The different nature of bad news and the chaotic situation in the emergency departments are the two most important points that may prevent using these guidelines in the emergency departments.
On the other hand, breaking bad news guidelines are designed based on Western cultures and their application in a non-Western country may decrease their effectiveness.To the best of our knowledge, there is no national guideline for breaking bad news in Iran. There is a long way to go before we can suggest a national guideline for emergency departments, so we recommend using one of the Western guidelines and indigenizing it according to the Iranian culture and emergency situations.
Maliheh Kadivar, Marjan Mardani Hamooleh,
Volume 8, Issue 1 (5-2015)
Abstract
Moral necessities in the field of children’s cancer are among the most important issues in medical services. The present study was conducted to explore this issue based on a case discussed during the medical ethics round in Tehran Children's Medical Center. A 13 year-old girl diagnosed with left ovarian cancer 5 years ago stated that she had not been informed about the disease and the type of surgery by her family, doctors and the medical staff. The family even denied the child’s disease, but she was struggling to adapt to the situation and eventually recovered after chemotherapy and surgery. Findings of the present study showed that through observance of moral necessities, health workers can assist children suffering from cancer and their families to better adapt to the situation. This is possible by providing supportive resources to these children as well as their families
Mehdi Aghili, Razieh Akbari, Ali Kazemian,
Volume 8, Issue 3 (9-2015)
Abstract
Truth-telling is considered as an important topic of modern discussion regarding the physician-patient relationship. The present study examined the behavior of physicians in disclosing the truth to patients. For this purpose, a total of 161 cancer specialists were selected using the simple random sampling technique. Research instrument consisted of a 24-item questionnaire based on expert opinion and the review of related literature. The results of item prioritization indicated that the participants ranked the following two items as highest in terms of attitude: "It is the basic right of patients to know about their condition", and "Relatives' participation in disclosing the truth to patients is rather beneficial". Research results also showed a positive and significant correlation between attitude and truth-telling tendency. Furthermore, multiple regression analysis by SMART-PLS software demonstrated that perceived behavioral control (self-efficiency) has the greatest impact on physicians' tendency toward truth-telling. The prediction power of planned behavior theory in predicting physicians' truth-telling behavior was established at 92 percent. Based on these findings, it is recommended to employ experts and adopt relevant guidelines to train novice physicians. Moreover, Iranian health officials are advised to take corrective measures to improve physicians' attitudes and subjective norms.
Bentolhoda Shirazi Sader , Siamak Afahin Majd , Shiva Rafati, Zahra Poshtchaman, Nahid Rejeh,
Volume 11, Issue 0 (3-2018)
Abstract
Considering the increasing prevalence of the malignant diseases and their great effects on the different aspects of the patients’ life and even their family, the disclosure of its diagnosis and trust telling to the patients have been changed to one of the main medical ethics challenges. This study aimed for the evaluation of patient’s tendency and their family to disclosure of malignant disease. This study was a cross-sectional research. It has been done with a questionnaire on the 270 people. The sample consisted of three groups: 100 patients without cancer disease, 100 patients’ family members, and 70 patients with cancer disease, who referred to Mustafa Khomeini Hospital. The data were analyzed through SPSS-16 software in this study, 74% of the patients with cancer and 85% of patients without cancer and 50% of patients’ families had tendency to know the diagnosis of malignant disease. In the case of prognosis, 39% of cancer patients and 75% of without cancer patients, were agreed to complete knowledge, and 42% of cancer patients and 22% of without cancer patients, agreed on relative knowledge. Regarding the result of this study and respecting the individuals' rights, it seems better for the patients with malignant disease to be informed of their diagnosis and prognosis by the health care workers. Furthermore, it would be better to implement strategies for improvement of patient-physician relationship through physicians' communication skills with patients.
Neda Yavari ,
Volume 17, Issue 0 (12-2024)
Abstract
Communicating the truth about a terminally ill patient’s diagnosis and prognosis is a profound ethical challenge in healthcare. While patients have the right to know the details of their medical condition, grounded in the ethical principle of autonomy, healthcare providers often grapple with concerns about causing distress or hopelessness. These concerns sometimes lead to paternalistic approaches where information is either manipulated or withheld from patients in end-of-life stages. Research on the timing, method, and extent of information sharing with terminally ill patients has yet to reach a consensus. The challenge is further complicated by cultural differences regarding death, as well as varying family and social dynamics. This article explores the views and experiences of both healthcare providers and patients regarding the ethical challenges associated with truth-telling in end-of-life care. This qualitative study involved semi-structured, in-depth interviews with 27 healthcare providers, 20 patients, and 15 caregivers. Participants were selected through purposive sampling, and interviews were conducted until data saturation was achieved. The data were analyzed using conventional content analysis. The findings were organized into four key themes:
1.Diverse methods of truth-telling employed by healthcare providers, influenced by personal values, institutional policies, and cultural contexts.
2.Patients’ and families’ preferences for receiving information, which frequently conflicted with healthcare providers’ practices.
3.The impact of timing, manner, and setting of truth-telling on the emotional health of both patients and their families.
4.The necessity for a patient-centered approach that acknowledges the unique circumstances, values, and preferences of patients and their families.
This research highlights the ethical complexities involved in truth-telling for terminally ill patients. While respecting patient autonomy is fundamental, the manner and timing of delivering the truth are crucial to maintaining trust in the physician-patient relationship and safeguarding the patient’s mental health. Further research should focus on developing effective communication strategies and support systems for healthcare providers engaged in end-of-life care. Educational programs should prioritize improving communication skills, cultural sensitivity, and ethical decision-making to enhance best practices and alleviate the emotional challenges faced by healthcare professionals in this sensitive area.
