We Don't Want Mom to Lose Hope-Please Don't Tell Her You're with Hospice! The Ethics of Truth Telling in the Setting of Serious lllness

•Discuss the 4 bioethical principles that are weighed when confronted with a request to withhold information from a patient with serious illness.•Gain knowledge and the ability to discuss current research regarding transparency in medicine.•Gain knowledge of the cultural dimensions of truth-telling and learn sensible ways to assess the impact of patient and family culture on their approach to transparency.•Learn ways to use a request to withhold information as an opportunity to have an explorative conversation about the requester's fears and values. As hospice gains wider acceptance, hospice utilization has increased. However, many family members are concerned about disclosing diagnostic and prognostic information to their seriously ill loved one. The reasons cited are diverse, but often evolve around fear that the patient will lose hope and “just give up.” Many family members worry that once the patient is aware that there is no cure available and death may be near, he or she will die sooner. As members of the hospice team enter a patient's home, they are frequently met with a request to “hide the truth” from the patient. This often includes a request to conceal the fact that the patient is receiving hospice services. Withholding such crucial information not only leads to moral distress for the staff, who feel that they are being dishonest, it also creates missed opportunities for the patient and family, ranging from processing the loss of their physical integrity to mending broken relationships and finding psychosocial and spiritual closure at the end of life. How can a request to withhold the truth be managed in the hospice setting? How can this request be used as a starting point for a meaningful conversation about the patient's and family's experience? In what ways can we show respect to the requester without robbing the patient of the opportunity to find closure and say good bye? An interdisciplinary team including a bioethics chair and interdisciplinary hospice team members will discuss the ethical dilemmas raised by the request for nondisclosure of important health information to seriously ill patients. The impact of non truth telling on patients, families and hospice staff will be addressed. In an interactive part of the session, audience members will be invited to proactively use this request to facilitate meaningful conversations with families and patients.