The attitudes of physicians and the general public toward prognostic disclosure of different serious illnesses: A nationwide survey

Abstract

AbstractBackgroundAlthough international guidelines recommend palliative care approaches for many serious illnesses, the palliative needs of patients with serious illnesses other than cancer are often unmet, mainly due to insufficient prognosis‐related discussion. We investigated physicians’ and the general public’s respective attitudes toward prognostic disclosure for several serious illnesses.MethodWe conducted a survey of 928 physicians, sourced from 12 hospitals and the Korean Medical Association, and 1005 members of the general public, sourced from 17 major cities and provinces.ResultFor most illnesses, most physicians (adjusted proportions – end‐organ failure: 99.0%; incurable genetic or neurologic disease: 98.5%; acquired immune deficiency syndrome: 98.4%; stroke or Parkinson’s disease: 96.0%; and dementia: 89.6%) and members of the general public (end‐organ failure: 92.0%; incurable genetic or neurologic disease: 92.5%; acquired immune deficiency syndrome: 91.5%; stroke or Parkinson’s disease: 92.1%; and dementia: 86.9%) wanted to be informed if they had a terminal prognosis. For physicians and the general public, the primary factor to consider when disclosing terminal status was “the patient’s right to know his/her condition” (31.0%). Meanwhile, for the general public the main reason for not disclosing prognosis was “psychological burden such as anxiety and depression” (35.8%), while for the physicians it was “disclosure would have no beneficial effect” (42.4%).ConclusionPhysicians and the general public strongly agree that disclosure of a terminal prognosis respects patient autonomy in several serious illnesses.