Withholding Information from Patients | AMA-Code (original) (raw)

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Truthful and open communication between physician and patient is essential for trust in the relationship and for respect for autonomy. Withholding pertinent medical information from patients in the belief that disclosure is medically contraindicated creates a conflict between the physician’s obligations to promote patient welfare and to respect patient autonomy.

Except in emergency situations in which a patient is incapable of making an informed decision, withholding information without the patient’s knowledge or consent is ethically unacceptable. When information has been withheld in such circumstances, physicians' should convey that information once the emergency situation has been resolved, in keeping with relevant guidelines below.

The obligation to communicate truthfully about the patient’s medical condition does not mean that the physician must communicate information to the patient immediately or all at once. Information may be conveyed over time in keeping with the patient’s preferences and ability to comprehend the information. Physicians should always communicate sensitively and respectfully with patients.

With respect to disclosing or withholding information, physicians should:

  1. Encourage the patient to specify preferences regarding communication of medical information, preferably before the information becomes available.
  2. Honor a patient’s request not to receive certain medical information or to convey the information to a designated surrogate, provided these requests appear to represent the patient’s genuine wishes.
  3. Assess the amount of information the patient is capable of receiving at a given time, and tailor disclosure to meet the patient’s needs and expectations in keeping with the individual’s preferences.
  4. Consult with the patient’s family, the physician’s colleagues, or an ethics committee or other institutional resource for help in assessing the relative benefits and harms associated with delaying disclosure.
  5. Monitor the patient carefully and offer full disclosure when the patient is able to decide whether to receive the information. This should be done according to a definite plan, so that disclosure is not permanently delayed.
  6. Disclose medical errors if they have occurred in the patient’s care, in keeping with ethics guidance.

Council Reports

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Opinion 2.1.1

Informed consent to medical treatment is fundamental in both ethics and law. Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care.

Opinion 7.3.2

Research on Emergency Medical Interventions

In certain situations and with special safeguards, it can be appropriate to provide experimental treatment without a participant’s informed consent. To protect the rights and welfare of participants in research on emergency medical interventions, physician-researchers must ensure that the experimental intervention has a realistic probability of providing benefit equal to or greater than standard care and that the risks associated with the research are reasonable in light of the critical nature of the medical condition and the risks associated with standard treatment.