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January 10, 1996

Patient-Physician Communication: Respect for Culture, Religion, and Autonomy

Author Affiliations

University of California, San Francisco

JAMA. 1996;275(2):107. doi:10.1001/jama.1996.03530260021010

To the Editor.  —Dr Blackhall and colleagues1 demonstrate that patients from different ethnic groups have differing attitudes toward autonomy and medical decision making. I agree with the authors' suggestion "that physicians ask patients if they wish to be informed about their illness and be involved in making decisions about their care or if they prefer that their family handles such matters" and believe it is also important to address the timing of such discussions.One option is to address this issue only when the need arises, for instance, when a test result reveals the presence of a serious illness. The advantage of this approach is that it limits the number of patients with whom the physician must discuss the issue to those few with an abnormal test result. However, a major problem with this approach is that when the physician has a test result indicating the patient has a