Non-disclosure of medical information in adult cancer patients : ethical and legal issues

Abstract

Requests for non-disclosure of medical information have existed since very early times. As time has progressed, there has been a shift from a paternalistic approach towards a more patient centred one. Yet, such requests still take place in the modern day, which bring about several ethical and legal issues. The first chapter shall focus on the ethical issues, where the concepts of truth, lying and trust shall be outlined, compared and contrasted. Furthermore, the ethical principles shall be outlined, and a theory pertaining to patient awareness shall be discussed. The Maltese population will also be discussed in relation to this issue. The second chapter of this dissertation shall highlight Maltese and EU laws, which pertain to the topic of non-disclosure of medical information, and the laws shall be assessed for benefits and limitations. Moreover, the topics of confidentiality and informed consent shall be underlined, and the duty of the physician and of the nurse in these processes shall also be discussed. Additionally, the topic of cognitive assessment shall be featured. The third chapter shall deal with the issue of breaking bad news. Studies shall be critically appraised to discover whether patients prefer to be told their cancer diagnosis or not. Also, any worries of healthcare professionals shall be outlined, and the education needs, which aid in breaking the news, shall be defined. The significant role of the specialised nurse shall be described. Lastly, the conclusion shall be a summary of the main issues discussed in this dissertation, focusing on methodology, any limitations and recommendations to improve patient care, while affirming that if the patient’s right to know their diagnosis is denied, so is their autonomy.