Skip to main content

Bioethics in a different tongue: The case of truth-telling

We’re sorry, something doesn't seem to be working properly.

Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.


After a survey of 800 seniors from four different ethnic groups showed that Korean-American and Mexican-American subjects were much less likely than their European-American and African-American counterparts to believe that a patient should be told the truth about the diagnosis and prognosis of a terminal illness, we undertook an ethnographic study to look more deeply at attitudes and experiences of these respondents. European-American and African-American respondents were more likely to view truth-telling as empowering, enabling the patient to make choices, while the Korean-American and Mexican-American respondents were more likely to see the truth-telling as cruel, and even harmful, to the patients. Further differences were noted in how the truth should be told and even in definitions of what constitutes “truth” and “telling”. Clinical and bioethics professionals should be aware of how their cultural and economic backgrounds influence the way they perceive ethical dilemmas and remember to make room for the diverse views of the populations they serve.

This is a preview of subscription content, access via your institution.


  1. Hare J, Nelson C. Will outpatients complete living wills? A comparison of two interventions. J Gen Intern Med. 1991;6:41–46.

    Article  CAS  PubMed  Google Scholar 

  2. Sachs GA, Stocking CB, Miles SH. Empowering the older patient? A randomized controlled trial to increase discussion and use of advance directives. J Am Geriatric Soc. 1992;40:269–273.

    CAS  Google Scholar 

  3. Caralis PV, Davis B, Wright K, Marcial E. The Influence of ethnicity and race on attitudes toward advance directives, life-prolonging treatments and euthanasia. J Clin Ethics. 1993;4:155–166.

    CAS  PubMed  Google Scholar 

  4. Teno JM, Fleishman J, Brock DW, Mor V. The use of Formal Prior Directives among patients with HIV-related diseases. J Gen Intern Med. 1990;5:490–494.

    Article  CAS  PubMed  Google Scholar 

  5. Sugarman J, Weinberger M, Samsa G. Factors associated with veterans’decisions about living wills. Arch Intern Med. 1992;152:343–347.

    Article  CAS  PubMed  Google Scholar 

  6. Murphy ST, Palmer JM, Aze S, Frank G, Michel V, Blackhall LJ. Ethnicity and advance care directives. J Law Med Ethics. 1996;24:108–117.

    Article  CAS  PubMed  Google Scholar 

  7. Blackhall LJ, Murphy S, Frank G, Michel V, Azen S. Ethnicity and attitudes toward patient autonomy. JAMA. 1995;274:820–825.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Leslie J. Blackhall MD.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Blackhall, L.J., Frank, G., Murphy, S. et al. Bioethics in a different tongue: The case of truth-telling. J Urban Health 78, 59–71 (2001).

Download citation

  • Issue Date:

  • DOI:


  • Advance Directive
  • Patient Autonomy
  • Cone Biopsy
  • Advance Care Directive
  • Terminal Prognosis