Truth-telling to Patients with Advanced Cancer: A Comparison between Cancer center, University Hospitals, General City Hospitals, and Private General Practitioners in Japan

Abstract

Attitude of Japanese doctors in their practice of truth-telling to patients with non-curable terminal cancer was extensively investigated to evaluate the difference between doctors from various types of medical institutions. A semi-structured interview using a questionnaire consisting of 18 items covering the doctors' attitudes towards truth-telling and their styles of informing patients about cancer diagnosis and prognosis was performed. Nominal responses to the questions were compared among 10 physicians from 1 cancer center, 71 from 7 university hospitals, 62 from 5 city hospitals, and 50 private general practitioners. The physicians from university hospitals, general city hospitals and/or general practitioners have significant tendencies that they were reluctant to tell negative information to patients both in terms of their inner perceptions as well as in their real clinical practice compared with those at cancer center from various viewpoints: seven perceptive questions (p < 0.05) and five practice questions (p < 0.05). This study shows that physicians in university hospitals, general city hospitals or private practitioners tell the truth in a less qualitatively and quantitatively explicit manner than those at the cancer center when caring patients with terminal-stage cancer in Japan.