Patients seen at the university hospital in Johannesburg: their views on truth-telling

[摘要] Truth telling forms part of the contemporary debate in clinical bioethics and centers aroundthe right of the patient to know honest information concerning his or her medical condition /illness and the duty of the doctor to inform the patient of such.Anecdotal evidence seems to imply that patients have concerns with the practice of truthtelling.Many often complain that they are not being informed and sometimes simply beingignored in matters that primarily concerns their health. On the other hand, there may bepatients who do not to want a truthful answer to their health problems-they would in factrather not know.The aim of this study was to explore my intuition that patients who attend the JohannesburgGeneral Hospital are not given full information about their condition(s) and / or treatment(s)although they would like to know.The study explored the preferences of patients regarding the practice of truth telling andtheir attitudes toward truth telling in four out patient clinics of the Johannesburg GeneralHospital.Four hundred and sixty five participants completed and retuned the questionnaire from fourdifferent out patient clinics, namely oncology, surgical (general surgery and orthopedics),medical (gastro, renal and general internal medicine) and the nuclear medicine unit thatrepresented the mixed out patient clinic.The majority of participants stated that the doctor had disclosed information about theircondition (92.90%). Almost all participants were of the opinion that patients have the right toknow about their condition (98.28%) and also that the doctor has the duty to inform them oftheir condition (98.02%).If they were suffering from a serious condition, a higher percentage of participants (86.28%)would prefer to know about their condition while a small but significant percentage (13.72%)would prefer not to know. The vast majority of participants (96.64%) also preferred to knowabout information relating to their treatment in detail while a high percentage (87.83%)supported disclosure to relatives.Variables such as gender, age and level of education did not seem to impact on theparticipants’ opinions of the truth telling process with significance with the exception ofivgender in relation with knowledge of one’s condition (p=0.0176) and education with regardto opinions on the right of patients to disclosure (p=0.0430).From the above results it can then be concluded that:1. Participants in our study supported the right of patients to disclosure and the vastmajority also felt that doctors have the duty to inform patients of their condition.2. A significant percentage of participants felt that the level of information given to themwas not satisfactory even when they have requested for more. This should be lookedat and means for improvement should be sought.3. A small but significant group did not support disclosure and must be respected asautonomous beings.4. Gender seems to influence opinions of patients concerning their condition andeducation impacts on opinions relating to right of patients to disclosure ofinformation.5. To our appeasement, we found that patients attending the Johannesburg hospitalare in fact given information about their condition. It is rather the quality and thequantity of information given that should be subject to scrutiny if we would like tomove towards full disclosure in the process of truth telling in our institution.6. Future studies should be considered to assess the attitudes of doctors towardsdisclosing, as well as further assess conflicting opinions in small group of patients bymeans of direct interviews.

[发布机构] University of the Witwatersrand