What if a family want to withhold the diagnosis or other important information from the patient?

There may be situations where a family is informed of a diagnosis before the patient, such as when a diagnosis is made during the course of an operation and disclosed to family while the individual is still recovering. In some cultures the tradition is for the family to be informed of the diagnosis first and to make all treatment decisions for the individual. Family may believe that by “protecting” the patient from the diagnosis the patient will be able to maintain hope. It is therefore important for a doctor to work through the following steps to fulfil the needs of the patient and the family.

1. Explore the values and beliefs that the family hold regarding medical treatment, illness etc.
2. Explain the principles upheld by Australian health care (i.e. informed consent, patient involvement in their own healthcare decisions, questions regarding medical treatment, potential unfinished business)
3. Explain to the family that the patient will be approached and asked if they wish to be informed of their diagnosis and prognosis or whether they prefer the family to be informed.
4. If the patient has requested that the family make decisions and that they not be informed as to their diagnosis, regularly revisit this to ensure that the patient is still comfortable with this approach.

Note: Some Aboriginal and Torres Strait Islander patients may want the right designated community member to be informed of the medical condition and to make the treatment decisions. It is best to clarify this situation with the individual.