CHapter 7 Truthfulness

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Philosophy

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Feb 20, 2024

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Chapter 7: Truthfulness True or False. Truthfulness as a value has always been important throughout history and across different cultures. True True or False. In earlier times, the medical profession condemned self- serving lies, but approved lies told for the benefit of patients. True First articulated in American case law in 1957 , _valid informed consent____ led to a massive change in terms of truth-telling in the health care profession. It wasn’t until the ___1980__s that the AMA said honesty was crucial , and in __2001____ it strengthened it’s position by writing, “A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.” Nonetheless, questions and complications remain with respect to telling the truth. We can ask, does beneficence ever justify deception? Does patient autonomy and respect for rights always rule deception out, even if it’s for their own good? [Do not answer these questions directly right here, just consider them as you read the case below.] Consider the following case: Karen, a 30-year-old woman with two small children, is admitted to the hospital after experiencing headaches, vomiting, memory loss, and partial paralysis. Dr. Smith runs numerous tests and discovers that Karen has a malignant brain tumor. It is advanced and untreatable, leaving Karen with only weeks to live. Before the tests, she had told Dr. Smith that she was terrified of cancer because her husband died of lung cancer and her mother of breast cancer. And if she succumbed to cancer, what would happen to her children? Who would care for them? Dr. Smith considers carefully whether to tell Karen of the dire prognosis. He thinks about the misery that full disclosure would cause her, the days spent in terror before the end, the dark depression that would likely spoil her remaining time with her children. He decides to shield her from the terrible facts, shrouding them in vague statements and irrelevant details. He tells her that she has a brain disease requiring neither surgery nor radiation, and he assures her that he has many

drugs at his disposal for treating her symptoms. Karen is relieved to hear the news and does not question Dr. Smith’s explanation. Sensing that disturbing details might lie behind his murky pronouncements, she presses him no further and tries to rouse a sense of optimism. She is eager to go home so things can get back to normal. The next day she does go home. But after two weeks of trying to resume her normal routine, after enduring more headaches and vomiting, she collapses and dies. Notice that in this scenario Dr. Smith does not actually lie to Karen (that is, intentionally give her false information), but he does deliberately mislead her by withholding crucial facts and avoiding definite statements. Either way, he handles her paternalistically. Notice also that this story is about protecting a patient from a dreadful prognosis, but such paternalism can also apply to the truth about diagnoses and treatments. [Reflection] Do you agree with what Dr. Smith did in this situation? Why or why not? What would you have done? Why? No, I do not agree with what Dr. Smith did in this situation because it his job as his physician to fully disclose the patient’s well-being to his fullest expense without regard to wanting the patient to feel better. I would have told her the truth because she would be able to enjoy her last days with her kids while also giving her time to arrange where her children will go if she has a potential family member to take them. I believe the patient should have a full understanding of what is going on in their body without sugarcoating it. Richard Cabot proposes truthfulness that truthfulness is what? Richard Cabots truthfulness is conveying one’s own impression or understanding of a situation, one can fail to be truthful by offering an incomplete or misleading explanation. Just as half-truths can mislead a patient, so also can “__snowing______” the patient with large amounts of technical or insignificant information , so that the patient cannot appreciate what information is most relevant and important. True or False. Patients have a right not to be informed about their situation. False

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