Would you like to know what is wrong with you? On telling the truth to patients with dementia.

Journal of medical ethics

PubMedID: 10786321

Marzanski M. Would you like to know what is wrong with you? On telling the truth to patients with dementia. J Med Ethics. 2000;26(2):108-13.
OBJECTIVES
To discover what dementia sufferers feel is wrong with them; what they have been told and by whom, and what they wish to know about their illness.

BACKGROUND
Ethical guidelines regarding telling truth appear to be equivocal. Declarations of cognitively intact subjects, attitudes of family members and current psychiatric practice all vary, but no previous research has been published concerning what patients with dementia would in fact like to know about their diagnosis and prognosis.

DESIGN
Questionnaire study of the patients' opinions.

SETTING
Old Age Psychiatry Service in Worcester.

PARTICIPANTS
30 consecutive patients with dementia.

RESULTS
The quality of information received has been poor and many patients have no opportunity to discuss their illness with anybody. Despite that almost half of the participants in this study had adequate insight and a majority declared that they would like to know more about their predicament.

CONCLUSIONS
Although many patients would like to know the truth, the rights of those who do not want to know should also be respected. Therefore the diagnosis of dementia should not be routinely disclosed but (just as in other disorders) health care professionals should seek to understand their patients' preferences and act appropriately according to their choice.