Family consent, communication, and advance directives for cancer disclosure: a Japanese case and discussion

The dilemma of whether and how to disclose a diagnosis of cancer or of any other terminal illness continues to be a subject of worldwide interest. We present the case of a 62-year-old Japanese woman afflicted with advanced ga ll bladder cancer who had previously expressed a preference nor to be told a diagnosis of cancer. The treating physician revealed the diagnosis to the family first, and then told the patient "You don't have any cancer yet, bu t if we don't treat you it will progress to a cancer", fn our analysis, we examine the role of family consent, communication patterns (including ambig uous disclosure), and advance directives for cancer disclosure in Japan. Fi nally we explore the implications for Edmund Pellegrino's proposal of '"som ething close to autonomy" as a universal good.