I. Executive Summary A policy brief presents a short

I. Executive Summary


            A policy
brief presents a short summary of  information that can
help readers appreciate, and likely make decisions about, government
policies (UNC, 2017). Disclosure of cancer diagnosis defined the level to
which patients openly discuss with others their diagnosis   and feelings and thoughts about their disease
to a range of common targets (Munro, Scott, King & Grunfeld, 2015). Disclosure
is considered an constant process with many complexities counting who is told (e.g.
healthcare professionals, family, friends, and colleagues), how much and what
must be said, when the time if it is planned or unplanned, or on purpose versus
brought about. Disclosure involves interaction where there may be responses, questions
and concerns on both sides.

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            cancer diagnosis for patient is
a bad news in the other words, the shock on the patient and family can be thinking
of as the hole between the patient’s expec­tations of the condition and the
medical reality of it. Second, it follows that, as a person who disclosing , he
can­not know how patients will respond to bad news un­til he determine their
perceptions of their clinical situations. so “Before you tell, ask.” to
be aware on patient behavior, beliefs,
thought, and predict the patient reaction toward cancer diagnosis.

purpose of this policy brief is to provide discussion and recommendation toward disclosure of cancer diagnosis
alternative, and it is directed to the Jordanian Medical Council (JMC)
via the Higher Education Faculty in the Hashemite University


II. Context and Importance
of the Problem


a cancer diagnosis and the connected prognosis is a frequent subject in Western
countries. The rising interest in this area has therefore lead to the
publication of guidelines intended to help clinicians with this critical task,
By contrast, for Middle Eastern medical communities specific data of this kind is
lacking (Farhat, Othman, el Baba and Kattan, 2015).

             We know
it is one of the patient rights to identify his disease, stage of disease and
treatment, for example one study in jordan talk about (Information
Needs and Disclosure Preferences among Jordanian Women Diagnosed with Breast
Cancer), it showed (92%) of woman wanted to
know the diagnosis breast cancer and (78%) in the stage of disease, but
Jordanian health care providers, specially physicians who withhold the truth
about cancer diagnosis and prognosis from their patients in a possible effort
to protect patients from distress and loss of hope. Although  main precedence information
needs for Jordanian women concerned in this study spread of the disease,
possibility of cure, and side effects of treatment (obeidat and khrais, 2014).

             Being diagnosed with cancer has
psychological, social and cultural consequences and many patients and their
relatives understanding psychological, physical, spiritual and family problems,
so the disclosure about it this is maintained and reinforced primarily because
of the mutual concerns of patients and family members (Motlagha et al., 2014).

            Cannot follow a standard procedure
when Disclosing the truth about a cancer diagnosis to a patient; because it depends
on many cultural elements. Factors such as education, spoken language
socioeconomic status, geographic area, urban or rural context, sex, occupation,
religion, and disability (Farhat, Othman, el Baba and Kattan, 2015).

physician and  patients communication
skill  is a core clinical skill that
health workers should be capable in. When the clinician is well qualified in
this art, his self-efficacy grows; he tends to readily uptake new communication
strategies and skills; and transfer of these strategies and  skills into the clinical practice (Adebayo,
Abayomi, Johnson, Oloyede and Oyelekan, 2013)



III. Critique of Policy


patients (96%) received their cancer diagnoses from physicians and the other
(4%) of patients were told by non physicians, which includes nurses, radiology
technicians, physician assistant, and relatives( Figg et al., 2017). So when
discloser the cancer diagnosis must be
consider the following: the issue of truth-telling, it is a difficult
business. From a health care viewpoint, it may be defined as total openness about
the diagnosis and prognosis For
health care professionals the difficulty and the dilemma of whether to tell the
truth or not A successful
relationship between patients and health care providers depends on the institution
of trust, which is strongly connected with truthful communication. On that
basis, truth-telling is considered to be an ethical issue as well as a moral responsibility
by a large number of health care professionals. likewise, patients expect that
their health care providers will tell them the truth, just as health care
providers expect that their patients will tell them the truth.

            at present the debate within
the USA is not whether patients should be told or not, but when and how to tell
them the truth. However, informative the diagnosis to a patient with cancer is
not fully accepted in some countries. Against countries with disclose the truth,
but full openness is still not a common practice. However, truth-telling is
considered an ethical issue as well as amoral responsibility by health care

disclosure policies recommend that they should provide full information. in
addition, the patients  right to
participate in decisions about their care is protected by legislation. However,
is it possible that these countries have moved too far the other way, Have
patients now lost the right not to have the whole truth and nothing but the

            Now days
in the development country health
care professionals present the available options to the patients and expect
them to decide. They may even avoid stating their professional belief because
they are afraid of being blamed by the patient if something goes wrong.

             In the lack of evidence as
to whether disclosing the truth or not affects patients’ quality of life, from
my point view  it is important to
reassess the argument that telling the truth is generally “good” for the


IV. Recommendations

Prepare and Have as much
information about the patient’s condition and communicate well,  This means knowing accurately what you are
diagnosing the patient with and why. Having
testing readily available so that you can walk during it with your
patient. Be honest with them if you believe a problem but need more testing or
a recommendation to know for sure.

Take your time , don’t give
a limited time because a person receives bad
news of any like cancer diagnosis, it is the body and mind’s instant reaction
to become over whelmed and somewhat shut down, don’t leave your
patient before he or she stops absorbing most of what you are saying.

Don’t over explained, Over-explaining
or going into too much depth can leave         your patient feeling confused and
“talked at” instead of “talked to.”

Be available
to answer questions, always end these discussions by allowing
the patient to ask you questions and Engaging him or her in this way will
give the chance to express any concerns or fears that may have arisen, as well
as make him or her feel like you truly care about the circumstances.


empathetic, try to put yourself in your patient’s
shoes, and try your best to remember that, most likely, he or she isn’t a
medical professional, and therefore, is hearing about the disease or condition
for the first time.