Codes of Medical Ethics: Disclousure of Terminal Illness

Country / Issuing Authority / Name (number) and Year of Issuance / Language / Relevant Text / Disclosure
To
Patient / To
Family
A) Arabic Countries
Bahrain / Prince of Bahrain / Practice of Medicine and Dentistry (7), 1989 / Arabic / Article (26): It is not permissible to any physician to disclose private information gained through medical practice, unless he obtains court permission or patient permission in writing, or if the disclosure to a first degree family member (spouse, father, adult children) is necessary either because of the seriousness of the disease or because of other reasons considered sufficient by the physician to justify such disclosure. / Silent / Allows disclosure if deemed necessary
Egypt / Minister of Health & Population / Medical Ethics Regulations
(238), 2003 / Arabic
English / Article (21): The physician may, for humanitarian reasons, conceal from the patient the critical consequences of the sickness, in which case he should inform his family in a humanitarian appropriate way the seriousness of the disease and its dangerous consequences, unless the patient expresses his desire to conceal his case from everyone or determine specific persons to be informed thereof and this did not constitute danger to those around him. / Allows concealment / Mandates disclosure if the patient is not informed
Iraq / Council of Medical Association / Medical laws and Regulations/6/1985 / Arabic / Article(22):It is the patient right to know the truth about his/her illness excluding disease that may lead to death, physician shall avoid telling the truth to his/her patient, and in this case the patient’s family who are responsible of the patient should be informed, but if family are not available and patient is in a good mental and psychological situation, he should be informed with proper precaution due to circumstances. / Prohibits disclosure / Mandates disclosure
Jordan / Ministry of Health / Jordanian Medical Practitioner law (13), 1972 / Arabic / Article (19): The physician may conceal the seriousness of the illness from patients. The high probability of death can be disclosed only with due care and diligence. The family should be informed if the patient is not informed. / Allows concealment / Mandates disclosure if the patient is not informed
Qatar / Ministry of Health / Law for Practicing Medicine, Dentistry and Dental Surgery (2), 1983 / Arabic / None / Silent / Silent
Lebanon / President of the Republic / Law of Medical Ethics (288), 1994 / Arabic / None / Silent / Silent
Saudi Arabia / Saudi Council of Health Specialists. / Medical Ethics Regulation (M#3), 1426,2005 / Arabic &
English / Article (3): Breaking the (bad) news about serious diseases:
There is no contradiction between reassuring the patient and informing him about his disease, even if it were a serious and fatal one. The patient generally has the right to know about his health condition, about the nature of his disease, and about its symptoms and complications. In addition, if the patient requested further details about the disease, his request should be fulfilled..
"The physician is to apply his own humane judgment as to the benefit of informing the patient with partial truth about his disease, or confine the informing the patient's relatives if he deems such as appropriate and in the Patient’s interest". / Allows concealment / Silent
Syria / Syrian Council of Medical Association / Duties and Ethics of the Physicians (7962/1/3-5/10), 1978 / Arabic / Article (17): Physician should not hide the seriousness of the disease from patient. High probability of death should be disclosed only with due care and diligence. When matter is concealed from the patient, it is recommended that the family is informed. / Allows concealment / Recommends
disclosure if the patient is not informed
Sudan / Sudanese Medical Council / Code of Ethics for Medical
Professionals, 1997 / Arabic / Section (B) Article (10): A physician may hide the seriousness of the patient condition, if he thinks it is the patient interest, in this case the physician should clarify the situation to guardian or close family member. / Allows concealment / Mandates disclosure if the patient is not informed
Yemen / President of the Republic of Yemen / Medical and Pharmaceutical Professions Practice Law, (26), 2002 / Arabic / Article (23): Professionals should observe confidentiality and should not disclose the secrets of their patients except to them or their first degree relatives if necessary, or in certain cases as other permissible by law. / Silent / Allows disclosure if necessary
Tunisia* / President of the Republic / Code of Medical Ethics (93-1155), 1993 / French / Article (36):1. Serious or fatal illness may be concealed from the patient.
2. It can be revealed, with greatest caution, only to the closest relatives, unless the patient has previously warned against that or has designated a third party to be informed. / Allows concealment / Allows disclosure
Algeria* / President of the Republic / Code of Ethics (92/276), 1992 / French / Article (51):1. Caution and care should be exercised when disclosing fatal illness. 2. Patients may be not informed about their fatal illness. 3. Family may be informed unless the patient warned from that. / Allows concealment / Allows disclosure
B) Islamic Non-Arabic Countries
Pakistan / Pakistan Medical and Dental Council / Code of Ethics 19th Council Session, 2001 / English / Article 14.Truth Telling: Patients should be told the truth because of the respect due to them as persons. Patients have a right to be told important information that physicians have about them. / Mandate disclosure / Silent
Malaysian / Malaysian Medical Council / Code of Professional Conduct, 1986 / English / None / Silent / Silent
C) International
World of Medical Association
(WMA) / International Code of Medical Ethics, 2006 / English / 7. Right to information:
b. Exceptionally, information may be withheld from the patient when there is good reason to believe that this information would create a serious hazard to his/her life or health.
e. The patient has the right to choose who, if anyone should be informed on his/her behalf. / Allows concealment / Prohibits
disclosure
Islamic Organizations for Medical Sciences (IOMS) / International Islamic Code for Medical Health Ethics,2004 / Arabic &
English / None / Silent / Silent
C) Western
Canada / Canadian Medical Association / CMA Code of Ethics (updated 2004) / English / Article (21): Provide your patients with the information they need to make informed decision about their medical care, and answer their questions to the best of your ability.
Article (35): Disclose your patient’s personal health information to third parties only with their consent, or as provided for by law. / Silent / Prohibits disclosure
United Kingdom / General Medical Council / Good Medical Practice, General Medical Council GMC-GPC, 2006 / English / None / Silent / Silent
USA / American Medical Association / AMA Ethics Policy, 2006 / English / CEJA Rep.2-A-06:
-Withholding pertinent medical information from patients under the belief that disclosure is medically contraindicated, a practice known as “therapeutic privilege”, create a conflict between the physician’s obligations to promote patient’s welfare and respect for their autonomy by communicating truthfully.
-Withholding medical information from patients without their knowledge is ethically unacceptable.
Physician should honor patient requests not to be informed of certain medical information or to convey the information to designated proxy, provided these requests appear to genuinely represent the patient own wishes. / Mandates disclosure / Silent

* Translated from French