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Stella Fitzgibbons, MD
MacGregor Medical Association Houston, Tex

JAMA. 1996;275(2):108.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Drs Carrese and Rhodes¹ offer us a detailed exposition of the Navajo view that bad outcomes can be avoided by not speaking or even thinking of them, a view refuted by the Navajos' own rate of morbidity and death from treatable and preventable diseases. The physicians find it "ethically troublesome" to discuss advance directives with hospitalized Navajos, a group who have already broken with that view by consenting to hospitalization.

It is time for a reality check when contributors to JAMA start asking physicians to avoid discussions of sickness, injury, and death, the very reasons our profession exists. Are we to withhold the facts about possible operative complications from Navajos faced with surgery? Or prescribe antibiotics without mentioning the infection they are supposed to treat?

Respecting our patients' views is both noble and necessary. But refusing to give them the facts about their condition and possible . . . [Full Text PDF of this Article]

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