VERY IMP: The guidelines is different for this post, GUIDLINES: Respond to a second student after searching CINAHL Database to explore Chinese cultural beliefs and practices related to disclosure of diagnoses.
In your reply, cite an article published in a professional journal, and based on that information, explain how you would weigh cultural considerations in deciding if it is ethical or not ethical to withhold the diagnosis from the woman in the case.
When dealing with the issue of whether or not to disclose information to a patient, one must think of the obligation that the APRN has to veracity. While the APRN has an obligation to tell the truth, what must be disclosed is sometimes a grey area (Beauchamp & Childress, 2019, p. 328). It is sometimes considered acceptable to delay, underdisclose, or even to not disclose diagnoses. One of those situations is when there are different cultural circumstances involved, much like the case of Mrs. Liu (p. 329). It is still common practice in many areas to avoid disclosing terminal diagnosis to patients as it may affect their hopefulness. This is especially true in low-income areas with less access to treatment. (Saqib & Pal, 2021).
Another reason that information may be withheld is to avoid complicating the decision-making process. Giving the patient too much information, too quickly may be unhelpful and also prevent them from making beneficial decisions for fear of unlikely side effects or consequences (Grace, 2018, p. 99) In Asian cultures it is common for family members to take charge of their elder’s medical care. They perceive their elders to be vulnerable and unable to take the stress of a poor diagnosis or making difficult medical decisions (Chittem et al., 2020). In Mrs. Liu’s case, it seems that her son is the one taking the lead of her medical care and also is doing so to protect her from the hopelessness and “death sentence” that she would feel coming from this diagnosis.
I think that this situation brings a tough dilemma that is a great starting point for our critical thinking in this course. I can easily see the benefits to both disclosure and nondisclosure in this situation. While I can understand the son’s reasoning, I feel that in this case with a diagnosis of tuberculosis, the results should be disclosed. This is not a terminal diagnosis, but it is one that will require very specific treatment as well as isolation precautions. With this being the case, I think it would be less stressful and fearful to Mrs. Liu to explain in a simple way, perhaps even without using the exact words “tuberculosis” to explain both this diagnosis and the treatment.
Children present a separate and unique ethical dilemma. Medical treatments require informed consent which means that the consenting party must be capable of understanding and making a decision with regards to both risks and benefits (Rosoff, 2017). There are certain states that allow “mature minors” to make their own decisions, but in most cases, it is the parent or guardian that decides and also decides what to disclose and withhold. My first questions is do you feel that diagnoses should always be withheld or always disclosed, or does it depend on the circumstance? My second question is how would you as an APRN encourage parents to involve their child in the education and decision-making process?
