Oral Presentation Australasian Association of Bioethics & Health Law and New Zealand Bioethics Conference

Is Chinese practice of non-disclosure a product of ‘familism’? A sociological and ethical study (1028)

Jing-ru Li 1
  1. Health Science Department, Medical School, Dunedin, Bioethics Centre, Dunedin

Patients in China are often not informed about their diagnosis or prognosis, particularly in cancer care. Instead, doctors will often inform the patients’ relatives, who then usually withhold the bad news from patients. It is widely believed that this practice is shaped by and compatible with the Chinese culture of ‘familism’ and is therefore ethically acceptable. In this presentation, I will briefly outline part of the findings of a qualitative study I undertook to investigate this practice in two cities in northern China: Tianjin and Beijing. On the basis of these findings, I will argue that the culture of familism may not be the fundamental contributor to such non-disclosure, and that a more crucial, and often neglected factor, is the difficulty most families have in breaking bad news to their family members, and a lack of professional support in doing this. In addition, I will argue that non-disclosure is often not beneficial in the ways that are supposed, and can result in adverse consequences, including but not limited to delayed treatment, non-compliance with treatment, mistrust between patients and relatives. As a solution, I propose a culturally sensitive approach to truth-telling, with special concern on how to decide if the patient should be informed and how to inform the patient.