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November 2017

Navigating Nondisclosure Requests in Pediatrics: Honesty and Sensitivity Are Transcultural Practices

Author Affiliations
  • 1Division of Quality of Life and Palliative Care, Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
JAMA Pediatr. 2017;171(11):1044-1045. doi:10.1001/jamapediatrics.2017.2934

In a world rich with diversity, practicing culturally sensitive medicine is a unique challenge. Western medical ethical principles do not always translate well to other cultures. This is especially the case with regard to disclosure of prognosis in patients with terminal illness, particularly pediatric patients.

In the review by Rosenberg and colleagues,1 the authors discuss the issue of request for nondisclosure of terminal prognosis using a hypothetical case example of Sara, a 15-year-old girl from the Middle East. A review of Western and Middle Eastern literature reveals great variability by country, medical specialty, and individual preference.2 The diversity of preferences underscores the importance of not making assumptions regarding patient and family values and beliefs and stresses the importance of individual assessments by the health care professional.

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