Critical Reviews in Oncology/Hematology 52 (2004) 165–172 Evolution of truth-telling attitudes and practices in Italy Antonella Surbone a,* , Claudio Ritossa b , Antonio G. Spagnolo c a Department of Medicine, Division of Medical Oncology, New York University, School of Medicine, 330 East 38th Street, Suite 5B, New York, NY 10016, USA b Division of Thoracic Surgery and Palliative Care, San Luigi Hospital, Turin, Italy c Sacro Cuore University of Rome, Department of Bioethics, Rome, Italy Accepted 1 September 2004 Contents Abstract ............................................................................................................................... 166 1. Introduction ....................................................................................................................... 166 2. Evolution of informed consent and truth-telling attitudes in Italy ........................................................................ 166 2.1. The role of the medical profession ............................................................................................. 166 2.2. Role of the public and of public discourse ...................................................................................... 167 2.3. The role of medical deontology ............................................................................................... 167 2.4. The role of the legislators ..................................................................................................... 167 3. Informed consent and truth telling in Italy: review of literature .......................................................................... 168 3.1. Informed consent in Italy ..................................................................................................... 168 3.2. Published data: review ....................................................................................................... 168 3.3. Inter-regional variations ...................................................................................................... 169 4. Discussion ......................................................................................................................... 169 4.1. The example of another country ............................................................................................... 169 4.2. Tradition and the law ......................................................................................................... 169 4.3. Growing multi-ethnicity in Italy ............................................................................................... 170 5. Concluding remarks ................................................................................................................ 170 Reviewers .............................................................................................................................. 170 References ............................................................................................................................. 170 Biographies ............................................................................................................................ 172 Abstract The debate on truth telling is at the core of contemporary biomedical ethics. Differences in truth telling arise from the delicate interplay between autonomy and beneficence in medicine, under the influence of cultural variables. Recently, a trend toward evolution of truth-telling practices has been noticed in countries previously known for non-disclosure. Italy is among them. This article analyzes in detail the different factors that have been influential in the Italian context, focusing on cancer patients. Medical profession, public discourse, medical deontology and legislators played an important role in Italy’s shift toward the western autonomy predicament. A review of the scanty published data on informed consent and truth telling in Italy, however, consistently shows that partial or non-disclosure are still present. This seems to represent a general trend in nations traditionally centered on family and community values. The article explores these issues to achieve a better * Corresponding author. Tel.: +39-02-43359622. E-mail address: asurbone@esoncology.org (A. Surbone). 1040-8428/$ – see front matter © 2004 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.critrevonc.2004.09.002