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Cited by 61Patient-Provider Communication in HealthcareDementia and Cognitive Impairment ResearchPalliative Care and End-of-Life Issues

Dilemmas in the (un)veiling of the diagnosis of Alzheimer's disease: Walking an ethical and professional tight rope

Karnieli-Miller, Orit, Werner, Perla, Aharon-Peretz, Judith, Eidelman, Shmuel·2007·Patient Education and Counseling
DOI 10.1016/j.pec.2007.03.014
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Abstract

Objective To enhance the understanding and effect of physician's difficulties, attitudes and communication styles on the disclosure of the diagnosis of AD in practice.Methods Qualitative, phenomenological study, combining pre-encounter interviews with physicians, observations of actual encounters of diagnosis disclosure of AD, and post-encounter interviews.Results There were various ways or tactics to (un)veil the bad news that may be perceived as different ways of dulling the impact and avoiding full and therefore problematic statements. In the actual encounters this was accomplished by keeping encounters short, avoiding elaboration, confirmation of comprehension and explicit terminology and using fractured sentences.Conclusion The present study's findings highlight the difficulties encountered in breaking the news about AD, in the way it is actually done, and the problems that may arise from this way of un/veiling the news. The main problem is that the reluctance to make a candid disclosure of the diagnosis as was demonstrated in this study may violate basic moral and legal rights and may also deprive patients and caregivers of some of the benefits of early disclosure of diagnosis.Practice implications There is a need for assisting physicians to cope with their personal difficulties, problems and pitfalls in breaking the news.

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Authors
Karnieli-Miller, O., Werner, P., Aharon-Peretz, J., & Eidelman, S.
Affiliations
  • University of Haifa (IL)
  • Rambam Health Care Campus (IL)
ORCID
Werner, Perla
Venue
Patient Education and Counseling
Publisher
Elsevier BV
Published
2007-08
Volume
67
Issue
3
Pages
307-314
ISSN
0738-3991 (ISSN-L)
DOI
10.1016/j.pec.2007.03.014
OpenAlex
W2029337114
Cited by
61
References
60
Citations by year
2026: 3 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 5 · 2017: 3 · 2016: 1 · 2015: 7 · 2014: 4 · 2013: 1 · 2012: 6
FWCI
8.52
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Patient Education and Counseling (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
Keywords
Alzheimer's disease, diagnosis disclosure, breaking bad news, physician-patient communication, physician attitudes, ethical dilemmas, early diagnosis, communication styles
MeSH terms
Adaptation, Psychological, Aged, Alzheimer Disease, Attitude of Health Personnel, Attitude to Health, Conflict, Psychological, Decision Making, Family, Fear, Female, Humans, Israel, Health Knowledge, Attitudes, Practice, Male, Negativism, Physician-Patient Relations, Physician's Role, Professional Competence, Professional-Family Relations, Surveys and Questionnaires, Truth Disclosure, Patient Rights, Qualitative Research

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