In very broad terms, differences in disclosure preferences can be somewhat delineated according to Eastern or Western philosophical orientation (Field and Copp, 1999). A terminal prognosis is generally not disclosed in Asian countries where passivity and acquiescence to authority are important traditions. Conversely, the same prognosis would usually be approached openly in the US and the UK and many European countries where autonomy and free will are widely valued. This paper aims to explore, analyze and find a way to better communicate terminal diagnosis and related prognosis to affected patients and their families.
Attitudes related to disclosure of terminal prognoses have shifted dramatically in the Western healthcare tradition, including the UK, over the past four decades (Chochinov et al, 2000). Research conducted in the 1950s and early 1960s revealed that only 10%-31% of physicians routinely disclosed a diagnosis of cancer to their patients (Fitch, 1994; Thomasma, 1994). This practice was due in large part to the widespread belief that such a diagnosis would create severe emotional disturbances that could potentially lead to suicidal acts (Thomasma, 1994). However by the late 1970s, nondisclosure practices had reversed (Fitch, 1994; Thomasma, 1994). This is evidenced by the 1979 survey results of Novack et al. which indicated that 98% of physician respondents disclosed the presence of terminal illness to their patients (qtd in Field and Copp, 1999).
Comprehensive aspects of end of life medical care have been brought to public attention through the development of both health psychology and behavioral medicine. Each field has made a unique contribution to the understanding that physical health is impacted by numerous biological, psychological, and sociological elements. The upsurge of interest in these biopsychosocial interactions led to an increase of studies in many areas, including that of