Engaging Requests for Nondisclosure During Admission to Home Hospice Care

It is not uncommon for hospice admission nurses to receive requests from loved ones to withhold information from patients about their diagnosis or prognosis. Such requests may occur in the context of similar requests having previously been honored by other, nonhospice care teams. This article explores the ethical questions raised by such requests and the motivations behind them. Following, it offers ways to engage requests for nondisclosure that honor ethical obligations to patients and families in a manner consistent with the hospice philosophy of care. The principles of truthfulness, sensitivity, and beneficence are introduced, and a framework using those principles to respond to requests for nondisclosure is proposed.