Family Disclosure of a Cancer Diagnosis to Patients

Importance: In Chinese culture, families often take primary control over disclosing a cancer diagnosis, balancing a desire to protect patients' emotional well-being with respect for their right to know. This dynamic can influence patients' psychological health and overall treatment experience. Objective: To examine decision-making dynamics, communication strategies, and power structures involved in how Chinese families balance the delivery of information with patients' psychological protection when disclosing a cancer diagnosis. Design, Setting, and Participants: This qualitative study used semistructured interviews with family members of adult patients with cancer in China. Purposive sampling ensured diversity in sex, age, and relationship to patients. Data collection and analysis were conducted simultaneously from June 1, 2024, to July 31, 2025, using thematic analysis. Main Outcomes and Measures: Key themes related to how families managed cancer diagnosis disclosure. Interviews elicited family members' expectations, decision-making processes, and strategies for balancing protection and patient autonomy. Results: A total of 41 family members were interviewed (median [range] age, 38 [21-56] years; 24 females [58.5%]). Four themes were identified: (1) family negotiation and decision-making on diagnosis disclosure, (2) conflict and collaboration between families and health care professionals, (3) implementation of family-led initial disclosure strategies, and (4) dynamic adjustment of disclosure strategies with treatment progression. These themes illustrated how families continually balanced protection and autonomy in evolving clinical circumstances. Conclusions and Relevance: In this qualitative study, cancer diagnosis disclosure within Chinese families unfolded as a culturally embedded and fluid process, requiring ongoing negotiation and adjustment among family members. Given the continued prominence of families in medical decision-making in China, future interventions should aim to bridge the gap between family involvement in care and patient autonomy. While offering necessary family support, these strategies should also aim to steer the disclosure model toward one that elevates and protects the patient's voice, thereby moving closer to internationally accepted ethical standards.