Truth telling in a South African tertiary hospital

Introduction. Truth telling forms part of the contemporary debate in clinical bioethics and centres around the right of the patient to receive honest information concerning his or her medical condition/illness and the duty of the doctor to give this information to the patient. Many patients complain that they are not being informed, but on the other hand there may be patients who do not want a truthful answer about their health problems. Objectives. This study explores the preferences of patients at four Johannesburg General Hospital outpatient clinics regarding the practice of truth telling and their attitudes towards it. Methods. Four hundred and sixty-five participants voluntarily completed and returned a questionnaire. Results. The majority of the participants stated that the doctor had disclosed information about their condition (92.9%). Almost all were of the opinion that patients have the right to know about their condition (98.3%) and also that the doctor has the duty to inform them of their condition (98.0%). If they were suffering from a serious condition most participants (86.3%) would prefer to know about it, but a small but significant percentage (13.7%) would prefer not to know. Variables such as gender, age and level of education did not seem to impact significantly on the participants' opinions about the truth telling process, with the exception of gender, as more females than males had knowledge of their condition (p=0.0176), and education, where more participants with higher education supported the right to disclosure (p=0.0430). Conclusion. The vast majority of participants supported the right of patients to disclosure, but the majority also considered that the level of information given to them was not satisfactory, even when they had asked for more. This implies a need to look at the way we give information to our patients and to seek ways in which this can be improved.