Question 1

Response 1
This is likely to be true. One study showed that 65 percent of Korean Americans believe that dying patients should not be told their prognosis. In fact, this is a common attitude among family members from many cultures. In some cultures, it may be seen as insensitive to tell a patient he or she is dying. It may be thought to create a sense of hopelessness and hasten the dying process. The very devout may believe that only God knows when someone will die. Among the Hmong, to tell someone they are dying is thought to curse them. How could you know they will die unless you plan to kill them yourself? Others may believe that by saying the words aloud, more energy is given to the possibility, thus increasing the chances that death will occur.

Response 2
While such news may cause an individual great despair and lead them to contemplate suicide, this is not something you would generally expect, nor is it a culturally appropriate answer.

Question 2

Response 1
While this satisfies the American values of autonomy and individualism and avoids potential legal problems, it conflicts with Korean cultural norms. In many Asian countries it is customary for the physician to reveal a cancer diagnosis only to the patient’s family, and leave it up to the family whether or not to tell the patient.

Response 2
While this may be appropriate for a physician to do in an Asian country, it poses a serious ethical dilemma for the physician to lie, and may create legal problems as well.

Response 3
This is the culturally appropriate choice. Although in many Asian cultures it is common for the physician to tell the diagnosis and prognosis to the family, rather than the patient, you cannot be sure whether or not the patient actually does want to know. Sometimes a well-meaning family tries to protect a patient from information the patient really does want. It’s always best to let the patient decide. If patients want to know, they will tell you to give them information directly. If they would prefer not to know, they will tell you to discuss it with a family member. In this situation, a physician should also check with the legal department of the hospital to see if there are any legal ramifications.