Asian Journal of Counselling



Diagnostic Nondisclosure of Schizophrenia to Chinese American Patients

2008.第15卷第1期(Vol. 15 No. 1).pp. 1–31
 

Diagnostic Nondisclosure of Schizophrenia to Chinese American Patients

臨床診斷是否適宜告知華裔美籍精神分裂症患者?

Wei-Chin HWANG(黃威誠)

Abstract

If a patient is diagnosed with schizophrenia, should the mental health practitioner disclose the patient’s diagnosis? What role might culture play in influencing this decision-making process? When mental health practitioners do not tell a patient his or her diagnosis, are they being more culturally sensitive and competent or are they feeding into cultural stereotypes and misconceptions? This article examines the controversial issue of diagnostic disclosure and why practitioners may be hesitant to reveal diagnosis of schizophrenia to their Chinese American patients. The impact of the patient’s ethnic background on diagnostic disclosure or nondisclosure and practitioner biases are discussed. In addition, results from interviews with four Chinese American psychiatrists are presented as illustrative examples of the diversity of beliefs, opinions, and practices that exist among mental health professionals. Practical implications and recommendations for addressing cultural issues in relation to diagnostic disclosure are provided.

摘要

如果案主被診斷患上精神分裂症,心理衛生從業人員是否適宜將診斷結果告知案主?在取捨的過程中,究竟文化扮演什麼角色?假如心理衛生從業人員選擇不告知案主其診斷,這是反映了該心理衛生從業人員的文化敏感度與文化知能,抑或反而加劇了該從業人員的文化刻版印象與錯誤觀念?本文探討應否將診斷結果告知案主的爭議,以及心理從業人員對告知華裔美籍精神分裂症患者其診斷結果態度遲疑的可能原因。本文亦討論案主的族裔背景對告知與否之間的影響,以及心理從業人員的偏見。此外,本文並述說與四位華裔美籍精神科醫師的訪談結果,藉以呈現心理衛生專業人員對這議題在信念、觀點與實務上的多樣性。最後,本文對牽涉是否告知診斷結果的文化議題提供實務上的建言與建議。