AMA: Doctors must tell patients the whole story

Shielding patients from bad news undermines the physician-patient relationship, a new policy states.

By Kevin B. O'Reilly, AMNews staff. July 10, 2006.

Chicago -- Physicians have an obligation to disclose, sooner or later, all relevant medical information to their patients, says new ethical policy adopted at the AMA's Annual Meeting in June.

The practice known as "therapeutic privilege" that allowed physicians to shield patients from medical information doctors believed would create needless distress or impede healing is no longer acceptable. According to the American Medical Association's new opinion, therapeutic privilege "creates a conflict between the physician's obligations to promote patients' welfare and respect for their autonomy by communicating truthfully."

The opinion gives physicians wiggle room to delay disclosing some medical information if they believe it's contraindicated, but the information should be disclosed over time and "according to a definite plan." The opinion also makes exceptions for emergency situations and after adverse events where liability risk is an issue.

Some physicians raised concerns that the new opinion could conflict with some cultural competency courses that advise physicians to respect differing cultural beliefs about disclosing medical information. "Some family members don't want you to tell a terminally ill family member that they're going to die," said Florida ob-gyn Madelyn E. Butler, MD.