Communication & CultureQuestion 34 of 200

A Chinese resident's family asks the CNA not to tell the resident she has cancer because in their culture it is harmful to inform the patient directly. The CNA should:

a.Tell the resident her diagnosis right away, since family cannot override her right to know
b.Inform the nurse and social worker so the team can navigate disclosure preferences in accordance with the resident's stated wishes and culturally sensitive practice
c.Promise the family that the CNA will never mention the diagnosis to the resident
d.Ignore the request and let the physician handle disclosure however he chooses

Explanation

Cultural practices around 'protective truth-telling' are common in many Asian and Latinx families, but the resident's right to know is paramount under 42 CFR §483.10(c). The team should ascertain what the resident wants to know (the resident may delegate decision-making to family). The CNA does not decide alone—she communicates the family's request to the nurse and social worker for ethical, culturally informed planning. Promising silence (c), unilateral disclosure (a), or ignoring (d) all bypass the proper process.

Law Reference: 42 CFR §483.10(c); shared decision-making

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