Truth-telling in a culturally diverse world

Until recently physicians have been reluctant to disclose a poor prognosis to patients for fear of harming them with the bad news and/or taking away their will to live. In the last decades we have seen a reversal of practice among Western physicians, and most doctors readily disclose to their patients the full extant of their disease. This change is probably due to the emphasis on patient autonomy in the doctor-patient relationship and the lack of evidence that hearing the bad news impacts significantly on patient outcomes. This emphasis on complete honesty with patients might not reflect the practice in non-Western cultures. In disclosing a poor prognosis to a patient the physician must do so with cultural sensitivity, compassion and letting the patient decide how much he or she wants to know.