A Request for Nondisclosure: Don't Tell Mother

Mrs. X was a 75-year-old woman who was admit-ted to the hospital with abdominal pain and se-vere depression. Her work-up revealed metastatic pancreatic cancer. Given her functional and nu-tritional status, her prognosis was less than 3 months. The patient had two daughters who were adamant that no one should tell their mom she has cancer. They understood that treatment was unlikely to prolong her life and wanted to take her home with hospice. You are unsure what to do— you feel like the patient has a right to know and yet her family is adamant that you cannot tell her because it will “kill her.” Requests for nondisclosure, as reflected in the case, may cause clinicians considerable distress.