[The right of not knowing: an intercultural palliative conversation].

Abstract

Communication in palliative care can be challenging when there are significant differences in the norms and values of patients and healthcare providers. In this article, we illustrate a case involving a 63-year-old woman who was admitted to the hospital due to abdominal pain caused by the progression of her metastatic melanoma. The patient was unaware of her metastatic melanoma, as this had been concealed from her by her daughter for protective reasons. During the admission, an extraordinary conversation took place to inform the patient about the diagnosis and her future prospects, in accordance with the Dutch Medical Treatment Agreement Act (WGBO). In this article, we discuss this conversation, Dutch legislation and regulations, and provide an overview of recent literature on the disclosure of diagnoses in different countries and cultures. We also discuss the TOPOI model in more detail, offering tools for healthcare professionals on how to approach intercultural conversations in palliative care.