Truth‐telling to the patient in advanced cancer: Family information filtering and prospects for change

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Abstract
This study investigated ‘truth telling’ to the patient in Navarre, Spain. Knowledge of diagnosis amongst a group of 89 advanced cancer patients was compared with the hypothetical desire for information of a convenience sample of 78 non‐patients. The views of patients' families were also assessed. Of the patient sample, 46% reported complete or partial knowledge of the diagnosis, whereas over 90% of the general population sample indicated that they would want complete or partial knowledge of the diagnosis. Two factors were found to be predictive of knowledge status amongst the patient group—including primary tumour site (lung/larynx vs breast) and the family's wish for the diagnosis to be withheld. Age and educational level were found to be predictive of attitudes towards ‘truth telling’ amongst the general population sample. These results indicate a clear wish for greater knowledge amongst (potential) patients. Although the family will almost certainly continue to play a central role in health care, it is concluded that there are already early signs of the desired trend towards greater diagnostic disclosure by families.