Abstract
Recently in Japan, the importance of informed consent for cancer patients has often been discussed. That for the patients with head and neck cancer is more important, because it is closely related to the quality of life. Truth disclosure is necessary for it, however, disclosure of a terminal illness is quite difficult, especially in Japan. Informed consent in the course of treatment in 61 patients with head and neck cancer who died after our examination and/or treatment were analyzed to clarify the present problems of telling the truth. In Nippon Medical School hospital, disclosure of cancer diagnosis was possible in 98% and that of recurrence of the disease was possible in 74% of the patients, however, that of a terminal illness was possible only in 9 % of the patients. These insufficient rates of disclosure were mainly because of psychological demerit for the patients. Truth disclosure including informing the patients about their terminal illness might be more important than before, considering the cost-effectiveness of cancer treatment and choice of maintaining the quality of life. One other problem about informing the patients truthfully is that terminal care performed at home and hospital is not sufficient for the patients and their families.
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