Q: If any patient is admitted to the hospital due to some health complaint, is it absolutely necessary to disclose everything in each step to the patient? This might increase the troubles of the patient. Nowadays, doctor's theory is to discuss everything in front of the patient. Yet, in most of the cases, the patient is not in a position to react to the situation. Please advise.

A:The general principle is to afford autonomy to the patient and family. By this we mean that the patient and family must be enabled to make all decisions regarding tests, treatment, the doctor playing the role of advisor. In order to make the decisions, the patient and family must be empowered by being given all relevant information. This is the reason why doctors now tend to discuss all aspects of the illness, tests and treatment. There is a difference of opinion among doctors on the approach when the illness is serious with an ominous outlook. Under such circumstances, should the patient be told the whole truth, knowing that this information may shock and demoralise and have a deleterious effect on the patients health? Many doctors tend to provide as much information as possible without shocking or demoralising the patient. Some information may be held back and divulged only if the patient asks specifically for it. As far as the family is concerned, however, the doctor will pass on ALL the available information including that on the catastrophic aspects of the illness for it is only fair that the decision-making relatives be kept fully informed. Where the patient is not in full possession of senses (as when the patient is unconscious or mentally unsound) all the information is passed on to responsible relatives and their decisions acted upon.