Requests to withhold information from a patient

Sometimes family members may ask that a patient not be told of their diagnosis or prognosis. It is helpful during these discussions to:

• acknowledge the family’s concerns
• ask about the reason for the request to withhold information from the patient
• consider the social and cultural factors affecting the situation. In some cultures, it is common to keep distressing news from patients
• discuss the benefits of honest and open communication. Explain that patients often already know they are dying, and talking about it allows them to discuss their concerns and receive appropriate support
• offer to ask the patient open questions in the presence of family members (and interpreter if appropriate), and be prepared to ‘back off’ if the patient does not wish to know any more
• advise the family that direct questions from the patient will be answered truthfully and sensitively when they arise.

For information about communicating with the patient, including breaking bad news and discussing prognosis, see Communicating with and supporting patients with palliative care needs.