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April 1, 1961

What to Tell Cancer Patients: A Study of Medical Attitudes

JAMA. 1961;175(13):1120-1128. doi:10.1001/jama.1961.03040130004002

A questionnaire and interviews were used to study the policies of 219 physicians about "telling" cancer patients. Ninety per cent indicated a preference for not telling. Although clinical experience was cited by three-quarters as the major policy determinant, the data bear no relation to experience or age. Instead, inconsistencies, opinionatedness, and resistance to change and to research were found which indicated emotion-laden a priori personal judgments as the real determinants. Feared reactions to telling (e.g., suicide) could rarely be substantiated. Equally undocumented assumptions were given as justifications for telling. Underlying were feelings of pessimism and futility about cancer. The strong feelings mobilized by our deep and serious concerns for cancer patients, and our difficulties in helping them, stimulate denial mechanisms. These responses, unfortunately, operate as interferences to progress in cancer therapy.