Medical Ethics: Why Might Healthcare Professionals Want to Lie?

ON MEDICAL ETHICS and LYING
© by Jensen DG. Mañebog/MyInfoBasket.com

Professionals in the field of medicine and healthcare sometimes find themselves in situations where they have to reconcile the general rule against telling lies with the fundamental principles of medical ethics. While they are as concerned to tell the truth as any other social group, there are cases where the presumption against lying can conflict with the principles of medical ethics (respect for autonomy, non-maleficence, beneficence, and justice).

Although truth-telling is not an openly stated principle of most systems of medical ethics, it is clearly implied by the principle of respect for autonomy. If patients are lied to, they cannot make a reasoned and informed choice, because they do not receive the information they need to do so.

Respect for patient’s autonomy is principally important in the case of people who are critically ill, as they are likely to be particularly vulnerable to manipulation of the truth.

Telling the truth is especially significant in obtaining informed consent. Healthcare professionals must tell the truth and ensure that the patient understands it properly when they are obtaining the patient’s consent to a procedure or treatment.

In principle, if patients are not told the truth, they cannot give ‘informed consent’ to the planned course of action. Patients can only provide informed consent if they know such things as the “truth about their illness, what form the treatment will take, how it will benefit them, the probabilities of the possible outcomes, what they will experience during and after the treatment, the risks and side-effects, and the qualifications and track-record of those involved in the treatment” (“Lying and Truth-Telling,” n.d.).

Moreover, patients do better after treatment if they have a truthful and full understanding of both the treatment and the illness. This is the case especially when patients are allowed to take some participation and control of the course of their treatment.

Debate on Lying in Medical ethics: Should medical professionals lie or not

Considering the ethical principles against lying, why might healthcare professionals want to lie? Generally, it said to be “for the good of patients.” The following are the common arguments for and against this sort of lying (“Lying and Truth-Telling,” n.d.):

a. Lying may be good therapy. And so the doctor may believe that the patient should only be given information that will help his/her treatment.

Against this point however, it is argued that lying deprives the patients of the opportunity to decide whether or not they want the treatment. Case in point is that of highly intrusive treatment near the end of life which may prolong life, but at immensely reduced quality. Patients, if truthfully and fully informed, might decline such treatment.

b. The truth may harm the patient. For instance, a patient may give up hope, go into a decline, or suffer a heart attack if given a truthful but depressing diagnosis and prognosis. Patients may even choose to kill themselves.

As a counter, some cite surveys which suggest that patients do not in general go into a severe decline or choose to kill themselves. Respect for autonomy is also cited as requiring the patient to be given the opportunity to consider all legal courses of action, no matter how undesirable others may think they are.

When lied to, patients may also realize sooner or later that the symptoms they experience and the way their respective disease progresses do not match what they have been told. In other words, they may experience other bad consequences of being lied to.

It is thus suggested that potentially hurting information should be given in a manner that minimizes harm. For instance, the patient should be appropriately made ready to receive the information and given proper support after being given bad news.

c. The patient, considering his/her health condition, will not properly understand the truth. It is thus impractical to tell him/her the whole truth.

Against this claim, it is argued that it is the duty of the professional to communicate the truth in a manner that each particular patient can understand, and to check that they really have understood it. Take note that honesty and intelligibility are particularly important when obtaining patient consent for a specific treatment or procedure.

d. The patient would go into denial and resist the truth if he/she were told it.

First, it is said that many patients do not go into denial. Second, the patient still has the right or choice to go into denial. Psychologically, denial may be a significant stage of coming to terms with the inevitable, so the patient must not be deprived of the chance of working through it and dealing with his/her own life-situation.

e. Especially in medicine, there is no certain or fixed truth: the future course of a disease is almost always uncertain. So truth-telling may be unnecessary.

Granting that there is no certain truth in medicine as regards one’s health situation, it is argued that the professional should still not lie. Healthcare professionals should instead give the patient the range and likelihood of possible outcomes concerning the case. (© 2013-present by Jensen DG. Mañebog/MyInfoBasket.com).

Also Check Out: From Socrates to Mill: An Analysis of Prominent Ethical Theories, also by author Jensen DG. Mañebog

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