Requests for non-disclosure can represent a loving family’s efforts to protect a patient from emotional harm, an inaccurate assessment by the family about a patient’s preferences or emotional resilience, or an accurate reflection of how the patient would prefer to make decisions.
Contemporary medical ethics and professional standards dictate that patients have the right to choose the medical care that best allows them to meet their life goals. To make such choices requires they be fully informed of their condition, prognosis, and reasonable treatment options. However it is necessary to differentiate the right to such information from the duty to hear the information.
Patients have different preferences for medical decision-making, ranging from individualistic, to paternalistic (doing whatever the physician recommends), to communal (sharing, or deferring, important medical decisions to family members or religious/community leaders).
Truly respecting patient autonomy requires clinicians to identify and respect patient wishes to share or defer decision-making, including a patient’s preference to not be informed of key medical information.