Bioethics in Nursing
Dr. Patrick Lee
November 11, 2014
Truth-telling and Lying in Healthcare
An older gentleman is diagnosed with end stage lung cancer and his family does not want you, as the healthcare provider, to divulge the poor prognosis to him because they believe the news would be burdensome to him. This type of scenario occurs a lot of the time. Do you tell the gentleman the truth as it is morally and ethically your duty as a healthcare professional or do you lie to him and go along with the families wishes?
People normally assume their healthcare provider will tell them the truth about their diagnoses, the results of tests, or in recommending treatment options. Traditionally, healthcare providers have not been as honest and open as patients expected them to be. Patients typically trusted their physician to tell them the truth and generally went along with anything they suggested because in the patients eyes the physician knows best. Some physicians felt patients could not handle the truth. In their eyes, they felt it was better to let the patient enjoy their remaining days happy instead of sad and depressed. Nowadays, truth-telling is highly valued in our society and most patients want to be informed.
The most common argument used to support truth-telling in healthcare is the principle of respect for autonomy (Slowther, 2009, p. 173). Autonomy requires that a person be adequately informed to make their own decisions. It is a form of personal liberty of action in which a person can determine their own course of action in accordance with a plan of their own choosing (Shannon & Kockler, 2009, p. 47). According to Slowther (2009), “there is a paradox in relation to autonomy and truth-telling in healthcare” (p.173). I know from personal experience, not even as a nurse, that physicians rattle off so much information when they are explaining a procedure they are going to do or they skip over some of the pertinent information you should know in order to be able to make an informed decision. So how can a person make an informed decision if their healthcare provider is not giving them all of the information they need to make a choice?
Despite what society perceives and professional ethical codes, there are situations when patients and families are not given specific or adequate information about the patient’s prognosis, even when they ask for it (Glass & Cluxton, 2004, p. 233). Not telling the patient or the family sufficient information can lead to problems which prevents patients and families from making informed decisions about treatment options which can deny them the opportunity to prepare themselves and their families for death.
What is lying? When I think of the word lying, I think that someone is not telling me the truth or being dishonest. In our society, there are varying degrees of lying like “white lies” or “fibbing.” For example, if you are shopping with a friend who really does not look good in a dress she is trying on, one might say to her that she “looks great”. Healthcare professionals usually tell “white lies” to their patients to cheer them up or make them feel at ease. Another example maybe a “false suggestion” where a person makes a true statement but omits out critical information so that the receiver ends up believing something false ("Truth Telling," 2007, p. 1). This can happen if a patient asks you if you have seen the results of their chest X-ray they have been waiting for and are anxious to get the results and the nurse implies that she has been too busy to check but in reality she knows the results but cannot say anything to the patient until the physician speaks to the patient. In both examples, information was withheld but was not done intentionally to be deceitful or cause false belief. A lot of times people, including healthcare providers, leave out irrelevant details but it can be done in a way that