CHOICES OF JAPANESE PATIENTS IN THE FACE OF DISAGREEMENT

Background Patients in different countries have different attitudes to ward self-determination and medical information. Little is known how m uch respect Japanese patients feel should be given for their wishes ab out medical care and for medical information, and what choices they wo uld make in the face of disagreement. Methods Ambulatory patients in f ix clinics of internal medicine at a university hospital were surveyed using a self-administered questionnaire. Results A total of 307 patie nts participated in our survey. Of the respondents, 47% would accept r ecommendations made by physicians, even if such recommendations were a gainst their wishes; 25% would try to persuade their physician to chan ge their recommendations; and 14% would leave their physician to find a new one. Seventy-six percent of the respondents thought that physici ans should routinely ask patients if they would want to know about a d iagnosis of Cancer, white 5% disagreed; 59% responded that physicians should inform them of the actual diagnosis, even against the request o f their of family not to do so, while 24% would want their physician t o abide by their family's request and 14% could not decide. One-third of the respondents who initially said they would want to know the trut h would yield to the desires of the family in a case of disagreement. Interpretation In the face of disagreement regarding medical care and disclosure, Japanese patients tend to respond in a diverse and unpredi ctable manner. Medical professionals should thus be prudent and ask th eir patients explicitly what they want regarding medical care and info rmation.