King Saud University Riyadh, Saudi Arabia
Correspondence to: Abdullah Al-Mobeireek, MD, FCCP, Department of Medicine (38), College of Medicine, King Saud University, PO Box 2925, Riyadh 11462, Saudi Arabia; e-mail: firstname.lastname@example.org
To the Editor:
The study by Ruhnke et al (October 2000)1showed
interesting differences between attitudes of American and Japanese
subjects to information disclosure and decision making. The situation
in Saudi Arabia is similar to that in Japan, and the family-centered
model is preferred. In a previous study,2 75% of
physicians in Saudi Arabia indicated that they gave information about
serious illnesses such as cancer to the family first and then the
patient if they approved. Physicians returning home after training in
North America experience not infrequently the ethical dilemma
highlighted by Ruhnke et al.
We feel that the increasing use of aggressive therapies nowadays and
greater awareness in the information era mandate greater patient
autonomy. This was also desired by patients in Saudi
Arabia.3 On the other hand, patients in the study of
Ruhnke et al wished for greater family and physicians’ involvement.
Thus, it seems that in the United States the concept of patient
autonomy has been overemphasized, while in Japan and Saudi Arabia it
deserves more emphasis. Obviously, the individual situation may
vary considerably, and we concur with the conclusions by Ruhnke et
al that physicians need to exercise some flexibility when performing
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