My Mother's Not to Be Told

The situation
My Mother's not to be toldThe patient's son approaches his mother's physician before they are to convene to discuss her condition. He tells the physician that in no uncertain terms is his mother to be told that she has cancer. The mother does not speak English, and so the son will be translating the doctor's words to her when they convene.

Communication issues
In many cultures, family members are the first recipients of information about a patient's cancer. We also see this when families fear the impact that the information will have on the patient and beseech the doctor not to reveal the information.

When family members attempt to control the information the patient will receive, it brings up ethical as well as communication concerns: how to safeguard the patient's autonomy and fulfill one's contract to her.

A language barrier and cultural issues are complicating factors in this scenario; the physician can't simply go and talk one-on-one with the patient, and while using a hospital translator (if available) would be an option, it might be one that antagonizes the family.

What to watch for
This interaction is actually a negotiation. Note the physician's exploration of the son's motives and fears, and then acknowledgement of his feelings. By using these techniques, he is able to avoid a standoff with the son, but maintain the patient's autonomy and the contract he has with her. Note what he asks the son to agree to.

View Vignette: My Mother's Not To Be Told (7:00)
Pearls & Pitfalls: Expert Comment (5:15)


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