Brain tumor patients’ views on deception: a qualitative study

Abstract

Given the trust the public places in the medical profession, the question of when it might be acceptable to minimally deceive patients, in their best interests, is a challenging one to answer. In this study, we explore neuro-oncology patients' attitudes towards dilemmas in which they may feel deceived, and with that information make recommendations on what steps physicians can take to avoid breaking that trust. Qualitative case study methodology was used. Thirty-two face-to-face interviews with post-operative brain tumor patients were conducted and recorded. Interviews were transcribed and subjected to modified thematic analysis. The majority of patients had a postsecondary education, and there was substantial religious and ethnic diversity among them. Five prominent themes arose from the analysis: (1) patients are hesitant about trainees working on their case, but they are more open to it if they expect the occurrence ahead of time; (2) patients wish to know the exact details when an error has occurred, even if it is of inconsequential effect for them; (3) patients generally prefer to know exactly what the doctor knows, even if nothing can be changed; (4) patients expect physicians to provide them with all the options and resources available; and (5) there are special cases in which patients accept a delay in knowing. Most neuro-oncology patients trust their physicians to make the best decisions for them, but that does not mean they would accept subtle forms of deception. Patients prefer to have all the information necessary in order to make their own decision.