2001 Fiscal Year Final Research Report Summary
Frameworks for Information Disclosure to the Terminally Ill -In an Ethics of Relationship in Japan-
| Project/Area Number |
12672287
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
基礎・地域看護学
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| Research Institution | Nagano College of Nursing |
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Principal Investigator |
KONISHI Emiko Nagano College of Nursing, School of Nursing, Professor, 看護学部, 教授 (70011054)
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| Co-Investigator(Kenkyū-buntansha) |
OKUBO Ikuko Nagano College of Nursing, School of Nursing, Assistant, 看護学部, 助手 (20301418)
OTA Katsumasa Nagano College of Nursing, School of Nursing, Professor, 看護学部, 教授 (60194156)
MITOH Takako Nagano College of Nursing, School of Nursing, President, 看護学部, 学長 (00086266)
MAYUMI Naoya Nagano College of Nursing, School of Nursing, Assistant, 看護学部, 助手 (10315848)
YAHIRO Michiko Nagano College of Nursing, School of Nursing, Assistant, 看護学部, 助手 (10326100)
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| Project Period (FY) |
2000 – 2001
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| Keywords | Information disclosure / Truth telling / Terminally ill patients / ethics in terminal care / Ethics of relationships |
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| Research Abstract |
This study, using data of our earlier studies regarding ethical issues in terminal care, took the next logical step and developed four possible frameworks for information disclosure to families and patients within an ethics of relationships. Framework A relies heavily on notions of doing no harm by withholdmg information from patients and having the family make decisions. The circumstances that this model is ethically used is only when the patient indicates that he/she does not want to know or when the family already knows the patient's intentions and has a good relationship with the patient. In framework B, the family receives the information first and the patient is told later. The delayed telling depends on the perceived readiness of the patient to hear this news. For the patient to know is not the same as the patient being told. Framework C requires the doctor to inform both the family and the patient about the patient's terminal illness. In this way, the family can help and support the patient when the patient receives this news. Framework D, informs only the patient about the diagnosis and prognosis and what these mean for the future. This would be most unusual except in those cases of patients who have no family.
These four frameworks were tested by l )family interviews, 2) physicians interviews, and 3) literature review. The results showed the following :
1) Framework D is seldom used. This family involvement in information disclosure is the norm in Japan.
2) Framework C fits most ethically with the Japanese ethics of relationship.
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