Table 1.

Examples of ethics of truth telling related to culture and country

Country/Cultural Group	Attitudes toward Truth Telling
China	When fatal diagnosis or prognosis is given, the physician informs the family and hides it from the patient—it is up to the family to decide whether, when, and how to disclose the truth to the patient; families usually decide to conceal such information, and physicians are willing to follow such decisions and cooperate with families in deceiving patients (39)
Black	Only God has knowledge and power over life and death, and physicians cannot have access to this type of knowledge; the Christian religious view held by many in the black community holds that suffering is redemptive—it is to be endured rather than avoided; forgoing life support to avoid pain and suffering, therefore, might be seen as failing a test of faith (9)
Italy	Trend of partial and nondisclosure persists; this arises within families independent of patient requests, although there is some evidence that physician preferences are moving toward full disclosure (40)
Spain	Tradition of partial and nondisclosure; the majority of doctors state that they would inform the patient only in certain circumstances or if requested by the patient (40)
India (Hindu)	Tradition of nondisclosure and relatives protecting the individual from knowledge in case he/she gives up hope and dies prematurely; this is exacerbated by the belief that modern medicine often provides hope, however unrealistic, that a cure is possible (41)