Reflecting on Withholding Truth in Healthcare: Impact on Patients

This reflective journal entry examines the ethical dilemma of withholding the truth from patients with life-limiting conditions, using Amy's story as a case study. The author explores the impacts of withholding information on the patient, family, and healthcare professional, considering the psychological and emotional effects. The reflection highlights how cultural practices influence patient care and decision-making, particularly in the context of Asian cultures where family involvement is central. The author discusses the challenges of balancing patient autonomy with cultural sensitivities, and proposes strategies for navigating these complexities, including open communication with both patients and their families, and adapting care to specific cultural needs. The piece concludes by emphasizing the importance of incorporating appropriate strategies when providing healthcare to patients with life-limiting conditions, acknowledging the critical interplay between cultural practices and the disclosure of sensitive information.

UNIT:
NAME:
DATE:

Introduction
The following write up is my reflection on withholding the truth about patient terminal
prognosis. It will contain the impact of withholding truth to the patient, family and I and how the
staff attitudes on patient’s and family cultural practices can affect care provided to the patient
and it impact on the patient and family psychological wellbeing. The write up will also contain
specific strategies that I plan to incorporate in such cases in my health care profession. The
reflection is based on Amy’s story case study.
Impact of withholding truth
a) To patient
Withholding the truth from Amy who has a life limiting condition has several impacts both
mentally and physically. First, withholding the truth causes anxiety to the patient due to lack of
knowing the condition of her health. The patient is not able to know what to expect that increases
anxiety leading to stress. The patient is also unable to make informed decision and accept
palliative therapies (Costantini et al. 2009).
b) To family
First, withholding the truth about the patient condition to the family leads to misinformation
about the patient’s emotions. Therefore the family is unable to offer appropriate support to the
patient. Withholding the truth also leads to unrealistic expectations which at the end are not met
destroying hope and trust.
c) To me
As a health care professional handling a prognosis patient, withholding the truth can cause stress
and discomfort. I will keep thinking about how to deal with the patient, patient’s family and
respond to patient’s emotions without depressing them to handle their negative feelings.
Withholding the truth will also cause misunderstanding from the patient on what to do and
expect.

Staff attitude about patient’s and family cultural practices
a) Affect care provided
Patients’ cultural practices are different across the world and they affect how a staff provides
health care. First, Amy is from Asian culture where illness is a family affair. This means that I
have to involve the family because the family is at the center of decision making (Fletcher,
2015). Secondly, disclosing the truth will require first to communicate with the family who
thereafter decides if to or not to disclose the truth to the patient.
b) Impact on Amy and her family psychological wellbeing
Amy, Mei, and Erik cultural practices would impact their psychological wellbeing regards
disclosure of prognosis information. The patient will experience emotional shock and denial
leading to stress after knowing her condition. The family is likely to experience their hope
destroyed that can cause depression. The cultures of Asian communities are not comfortable with
prognosis truth as it extinguishes hope to the patient and family (Hancock et al. 2007).
Strategies to incorporate
First, I will hold discussions with the family and the patient to find out what they know about the
condition. Secondly, I will find the most appropriate time to disclose the truth about the
condition. I will then communicate and encourage the patient’s family to accept the prognosis
condition. Lastly, I will inform the family regarding the patient’s emotions and the appropriate
support that they can offer to the patient (Sarafis et al. 2014).
Conclusion
From the following reflection on the Amy’s story, I have learnt that withholding or disclosing
truth about patient’s prognosis condition has impact to the patient, family and the health
professional providing the health care. Telling the truth to a patient or patient’s family is
influenced by the cultural practice that they belong to. Therefore, it can be said that appropriate
strategies are important to incorporate when providing health care to a prognosis condition.

References
Costantini, A., Baile, W. F., Lenzi, R., Costantini, M., Ziparo, V., Marchetti, P., & Grassi, L.
(2009). Overcoming cultural barriers to giving bad news: feasibility of training to
promote truth-telling to cancer patients. Journal of Cancer Education, 24(3), 180-185.
Fletcher, J. F. (2015). Morals and Medicine: the moral problems of the patient's right to know
the truth, contraception, artificial insemination, sterilization, euthanasia. Princeton
University Press.
Hancock, K., Clayton, J. M., Parker, S. M., Wal der, S., Butow, P. N., Carrick, S., ... &
Tattersall, M. H. (2007). Truth-telling in discussing prognosis in advanced life-limiting
illnesses: a systematic review. Palliative medicine, 21(6), 507-517.
Sarafis, P., Tsounis, A., Malliarou, M., & Lahana, E. (2014). Disclosing the truth: a dilemma
between instilling hope and respecting patient autonomy in everyday clinical practice.
Global journal of health science, 6(2), 128.