Disclosure of cancer diagnosis and prognosis in Northern Tanzania

Julian J. Harris, John Shao, Jeremy Sugarman

Research output: Contribution to journalArticle

Abstract

Whether to tell patients with cancer about their diagnoses and prognoses is a matter of great debate. While many argue the importance of giving this information to facilitate informed decision-making, others argue that this same information can extinguish hope. Although there is some evidence that disclosure of this information is now commonplace in many Northern and Western settings, there are very few data about this issue from resource-poor nations describing physicians' decision-making regarding whether to disclose this information. Using a combination of ethnographic and other qualitative methods including participant observation, semi-structured interviews, informal interviews, and a review of key documents in Northern Tanzania, we map some of the salient issues in this setting. Like their colleagues in many other parts of the world, Tanzanian physicians often withhold diagnostic and prognostic information from patients. In addition, however, to the cultural arguments often used to justify this practice, issues of treatment availability and patient poverty also influenced the physicians' disclosure practices. Expatriate and Tanzanian physicians practicing in Northern Tanzania often had different approaches to informing patients of their diagnoses and prognoses. Some Tanzanian physicians advocated the use of a "roundabout" approach to disclosure, arguing that it was more reflective of the normal mode of discourse in Tanzania than the more direct approach advocated by many of their expatriate colleagues. Expatriate physicians and some of their Tanzanian colleagues felt that such an indirect approach often left patients confused, or indeed, uninformed.

Original languageEnglish (US)
Pages (from-to)905-913
Number of pages9
JournalSocial Science and Medicine
Volume56
Issue number5
DOIs
StatePublished - Mar 1 2003
Externally publishedYes

Keywords

  • Cancer
  • Disclosure
  • Ethics
  • Tanzania
  • Traditional medicine
  • Truth-telling

ASJC Scopus subject areas

  • Health(social science)
  • History and Philosophy of Science

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