Terminal illness in Japan: do doctors inform patients of their diagnosis?

ISTR reading maybe 10-20 years ago that doctors in Japan who diagnose elderly patients with a terminal illness tend not to inform said patients of their diagnosis, preferring not to cause mental distress.

Is there any truth to this, either now or at any time in recent decades? Or was this just some xenophobic urban legend?

According to this at least your general premise is correct.

“Physicians in Japan typically do not disclose diagnoses of terminal illnesses to patients, in deference to the wishes of family members.”

Why that would be the case in Japan, compared to most other countries, I can’t say.

Yes, I know of people whose family members had cancer and the doctors would not tell the patient of the prognosis. This may be changing now.

It was thought that the people would lose the spirit to fight if they knew they were dying.

Hold on a moment. Does this mean that the doctors asked the family if they want to tell the patient about his/her terminal condition? That would seem to be an invitation for all sorts of unethical conflict-of-interest situations.

“Hey, Dad’s got a lot of money in the bank, right? Let’s not tell him about the brain cancer, so he won’t spend it on treatments, OK?”

That used to be the practice in the US, too - the doctor might (or might not) tell the family, but would leave it up to them to tell the patient.

Cite: Cat on a Hot Tin Roof.

As someone with more than my share of terminally ill relatives it usually comes down to one of these reasons:

Doctor isn’t 100% sure the illness can’t be brought under control.

Doctor knows the next question will be “how long do I have” and knows “anywhere from three months to five years” doesn’t really count as an answer.

Doctor fears patient is in denial and would probably just walk out, thus missing out on palliative care.

Doctor fears patient will give up. (That doesn’t just mean forgoing treatment, it can also mean something like a diabetic with heart failure refusing to take insulin.)

Here’s another cite, talking about it being a cultural sensitivity issue:

http://jop.ascopubs.org/content/6/2/94.full

Don’t a significant proportion of elderly have some abnormal cell growth? Whether it’s a benign tumor or isn’t but won’t kill the patient before something else is likely to give out first, would telling them help them in any way?

Or Mad Men, which surprised me.

I was also surprised to hear that in the UK (or Northern Ireland at any rate) not telling someone about a terminal illness was sometimes held in notes on the benefits computer system. At least, according to someone in my office who transferred over from that sort of a business area.

This was mentioned as the routine practice with terminal cancer patients in Sayers’ “Unnatural Death”, set in the 1920s in England. Of course, in that case the terminal patient is hurried along a bit…