Truth Disclosure to Cancer Patients: Shifting Attitudes and Practices of Lebanese Physicians

Abstract

Background: The disclosure of cancer diagnosis is globally shifting toward preserving patients' autonomy and acknowledging their right to have complete information about their health. In 1995, a survey conducted in Beirut showed that 47% of physicians having potential contact with cancer patients preferred to disclose the full truth to their patients. This study examines current disclosure practices and factors affecting them among Lebanese physicians and compares the results to those of the 1995 study. Methods: A self-administered questionnaire was distributed to and completed by a sample of physicians with potential direct contact with adult cancer patients in the Greater Beirut area. Quantitative methods were used to analyze responses concerning usual disclosure practices, physicians' attitudes and beliefs concerning disclosure, and patient- and physician-related factors affecting disclosure practices. Results: Of the 500 participating physicians, 69% preferred to disclose the full truth to their patients (“Disclosers”). Disclosers were significantly younger, had higher numbers of weekly practice hours, and were more involved in medical teaching than Nondisclosers. Most Disclosers attributed their disclosure practices mostly to medical education and professional experience. They were more likely to believe that patients have the right to know everything about their health, that full disclosure is actually their patients' preference, and that the disclosing physician should preferably be the primary care physician. Conclusions: The percentage of Lebanese physicians who prefer to tell their patients the full truth about a serious diagnosis is increasing, mostly among younger, better informed, more professionally aware practitioners. The trend suggests that disclosure is on its way to becoming a normative practice.