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Disclosure of cancer diagnosis and prognosis in Northern Tanzania

Author

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  • Harris, Julian J.
  • Shao, John
  • Sugarman, Jeremy

Abstract

Whether to tell patients with cancer about their diagnoses and prognoses is a matter of great debate. While many argue the importance of giving this information to facilitate informed decision-making, others argue that this same information can extinguish hope. Although there is some evidence that disclosure of this information is now commonplace in many Northern and Western settings, there are very few data about this issue from resource-poor nations describing physicians' decision-making regarding whether to disclose this information. Using a combination of ethnographic and other qualitative methods including participant observation, semi-structured interviews, informal interviews, and a review of key documents in Northern Tanzania, we map some of the salient issues in this setting. Like their colleagues in many other parts of the world, Tanzanian physicians often withhold diagnostic and prognostic information from patients. In addition, however, to the cultural arguments often used to justify this practice, issues of treatment availability and patient poverty also influenced the physicians' disclosure practices. Expatriate and Tanzanian physicians practicing in Northern Tanzania often had different approaches to informing patients of their diagnoses and prognoses. Some Tanzanian physicians advocated the use of a "roundabout" approach to disclosure, arguing that it was more reflective of the normal mode of discourse in Tanzania than the more direct approach advocated by many of their expatriate colleagues. Expatriate physicians and some of their Tanzanian colleagues felt that such an indirect approach often left patients confused, or indeed, uninformed.

Suggested Citation

  • Harris, Julian J. & Shao, John & Sugarman, Jeremy, 2003. "Disclosure of cancer diagnosis and prognosis in Northern Tanzania," Social Science & Medicine, Elsevier, vol. 56(5), pages 905-913, March.
  • Handle: RePEc:eee:socmed:v:56:y:2003:i:5:p:905-913
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    Citations

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    Cited by:

    1. Daniel Sippel & Georg Marckmann & Etienne Ndzie Atangana & Daniel Strech, 2015. "Clinical Ethics in Gabon: The Spectrum of Clinical Ethical Issues Based on Findings from In-Depth Interviews at Three Public Hospitals," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-15, July.
    2. Mei, Xiao & Tu, Jiong, 2021. "Values, skills, and decision-making: A cultural sociological approach to explaining diagnostic disclosure," Social Science & Medicine, Elsevier, vol. 279(C).
    3. Malambo, Nomthandazo, 2021. "“Not from home”: Cancer screening avoidance and the safety of distance in Eswatini," Social Science & Medicine, Elsevier, vol. 268(C).

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