Being open and honest with children about their medical condition and treatment is generally regarded as ethical best-practice in child and adolescent health care. However, this is not always straightforward in practice. One difficulty is parents asking clinicians to withhold information from their child. In this paper, we are presenting findings from a study about how paediatric clinicians think about and manage these situations where parents tell them not to give the child certain information. This presentation is based on interviews with 20 clinicians, in which nearly 50 instances were described.
Our findings show that clinicians find these situations particularly challenging. Broadly speaking, clinicians wanted to tell the child the information in question, and tended to try to persuade parents to allow this. Most, but not all, parents were reported to have eventually accepted their child being told. If clinicians agreed not to tell, it was generally a short term measure – they believed that it wasn’t something that could be or should be sustained long-term. We discuss reasons clinicians gave in favour of telling the truth and what they understood to be parents’ reasons for not telling. To finish, we also discuss a number of the nuances that are arising from thematic analysis of the data, which indicate that there are still aspects that are ethically murky. One of these is the use of euphemisms, or choice of words which could be seen as skirting or glossing over the issue.