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For a woman in her mid-30s with a newborn and elderly parents to look after, the news could hardly have been worse. She had just been diagnosed with an aggressive form of thyroid cancer that usually afflicts the elderly and is usually lethal.

Her doctor, though, decided not to reveal the bleak statistics — 95% of patients live no longer than a year. As the new immigrant’s husband translated, the physician said only she had a tumour and it may not be curable.

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“If [the specialist] was much more blunt about it and said, ‘You’ll probably be dead in six months,’ it could be harmful,” said Dr. Karen Devon, a surgeon at Toronto’s Women’s College Hospital. “I don’t think that information is necessarily helpful.”

Not all doctors would agree. Modern medicine and the concept of “patient autonomy” that is supposed to guide it encourage physicians to hold little back when explaining someone’s prognosis, even if it means delivering the worst possible news.