Benevolent Deception

According to Higgs, one reason why a medical profession might withhold the truth from the patient is that : it may actually do harm through anxiety and distress that's produced after disclosing the truth. At times, truth-telling can lead to major/acute distress or long term disability. There can also be times where distress and fear can lead to a more severe condition of an illness or even causing a patient to deny the treatment. In either way, there is a high chance that the worsening of the illness may occur after a physician disclosing the truth to his/her

Another issue with the implementation of Informed consent arises when the patient waives the right to Informed consent and leaves the right to make the decision on the physician. Though legally correct, this can cause psychological stress for the physician especially when the decision is about a life threatening medical condition. Moreover, this also makes the patient vulnerable to abuse. (Manthous, DeGirolamo, 2003)

Goldman’s critique of medical paternalism demonstrates the right for patient autonomy and decision to choose a treatment best suited to their needs and interests. Initially, physicians would not announce any form of cancer to their patients, as it was believed to result in physiological distress. Luckily, medical paternalism continues to be rejected in medical situations; the topics of outcomes research, scientific evidence, and court decisions help correct patient decisions on the best treatment.

Being a doctor requires a lot of hard work and commitment to help others and look for the patient’s well being, but has it always been this way? In “The Immortal Life of Henrietta Lacks” by Rebecca Skloot, she claims in paragraph 4 on page 130 that doctors used to withhold information from patients just so they won’t deny the test being made, and this way obtain their wanted benefit. The author’s claim is supported by the events of the patients from jail, Henrietta’s autopsy, and Henrietta’s cells overall.

To argue the first premise, he appeals to common knowledge that doctors hold their occupations because they are more knowledgeable in a medical context on the options for improving health and longevity. With this in mind, he then establishes that individuals who consult physicians do so in order to prolong their life and improve their well-being. By establishing these foundational premises for paternalism in a medical context, Goldman can now argue that given a patient that is determined to be acting out of line with his true values and his actions might result in harm that is severe, certain, and irreversible, it is the physician’s professional to override the patients’ immediate rights in order to preserve that patients’ more long-term desires. But how can the physician determine whether the patient is acting in line with his true values in the case of withholding medical information from the patient?

Currently, most people generally accept a doctor’s word as truth and do not question him or her. When it comes to the medical field, patients can often feel overwhelmed by all the confusing medical terms being thrown at them, so they tend to sit back and do as the doctor says. Healthcare professionals sometimes take advantage of this fact and withhold important information from their patients. For instance, a study conducted by Lisa Lezzoni, MD, and her peers states that more than half of physicians lied to their patients about their diagnosis to put a more positive spin on it (Lezzoni, Rao, DesRoches, Vogeli, and Campbell). Healthcare professionals should disclose to the patient any information pertaining to the patient.

De Bord, J. (2014). ETHICS IN MEDICINE University of Washington School of Medicine. Retrieved from https://depts.washington.edu/bioethx/topics/consent.html

The relationship between a patient and his or her doctor was trustworthy to the point where the patient did not ask their doctor questions. Skloot describes this concept by stating, “There’s no indication that Henrietta questioned him; like most patients in the 1950s, she deferred to anything her doctors said. This was a time when “benevolent deception” was a common practice- doctors often withheld even the most fundamental information from their patients, sometimes not giving them any diagnosis at all” (63). Patients at this time trusted their doctors, and this corresponds to this thought of ‘doctors knowing what’s best and to not question it.’ Skloot was not sure if Henrietta actually questioned her doctor, but she was definitely sure of the concept, ‘benevolent deception,’ being an accepted tradition in the medical field at that time. Another example of deception is, “But Southam wasn’t their doctor, and he wasn’t withholding upsetting health information. The deception was for his benefit- he was withholding information because patients might have refused to participate in his study if they’d known what he was injecting” (130). By not telling patients about injecting them with HeLa cells, Southam was putting them at risk. Despite the fact that they might have declined to cooperate in this study, patients still have the right to know and to be asked for

Informed consent is an integral part of the medical process, but what is it? How can the principles of Informed Consent conflict with each other or with patient care? It is important to examine Informed Consent very carefully and explore how the principles of Beneficence and Patient Autonomy work with each other for the best interests of the patients, even if the patient is refusing some treatment that is important in the standard of care. However, it may be possible that Informed consent and these elements work against one another, and conflict with the best interests of the patient.

A patient could feel that it is unfair to be denied what they believe their right to die is. There are additional issues that a patient could experience along with the loss of their health. There is the loss of privacy, pride, and dignity when unable to care for self.

“Professional integrity derives its substance from the fundamental goals or mission of the profession” (Wakin, 1996, para. 15). Meaning to say, individuals seek for a professional’s valued and ethical advice to which the professional holds their responsibility to maintain and exceeds the level of their expertise. For example, a general practitioner will treat a variety of patients, from all different walks of life with a plethora of different problems. It is their duty to diagnose and treat the patient to the best of their professional ability without prejudice. Another aspect of their duties is the principle of patient confidentiality. Medical professionals are legally bound to not divulge any information provided to them by their patients.

If patients don’t get the right to choose, they might refer to illegal methods to die or even commit suicide.

Yeo (2010) point out that the possibility to retain some information from patients has been ordered for long in Australian law, as in other countries for the benefit of the patient. This has now been combined with the greater autonomy acknowledged to the patient in many jurisdictions. Although a clinical approach reveals that loyalty should guide the patient-physician relationship, there are still some situations in which information consent and truth telling may be controversial: in some circumstances, the physician should or may not tell the truth. The case at hand poses a dilemma regarding the right to know (Cherry & Jacob 2008).

Michael H., a 68-year-old man, was admitted for exploratory surgery of his abdomen. He is frail, and his attending physician describes him as “emotionally labile.” Marcy R. is a social worker at BFL General Hospital, who is assigned to the unit that Michael H has been admitted. After Michael’s surgery, Marcy R. was approached by Michael H.’s daughter, Ellen B. in which Ellen has told Marcy that her father’s physician had just informed her that the lab report from the exploratory surgery shows that her father has terminal cancer. Ellen said that she and the family are in shock and they have decided that they not want the hospital staff to tell her father about the terminal nature of his cancer once he recovers from anesthesia. In this essay, I will discuss the ethical dilemma of “to tell Michael or not to tell him he has terminal cancer. He has the right to confidentiality by not withholding information from him when he has been diagnosed with terminal cancer, informed consent, and self-determination.

Lying in medicine seems to be a requirement for doctors because they think that truthful information can hurt patients (Bok 222). According to doctors, while they are telling the truth, patients may have a heart attack or their psychological mechanism might be alleged. Furthermore, death comes more quickly. However, these are so rare and considering these universal is an overgeneralization. In addition, doctors consider their patient as a child and see them like a blind, suffering and passive toy (M.Smith and M.Weil 22); hence, doctors think that they can make choices for their patients without telling the truth to patients. However, this opinion just shows doctors’ paternalistic view (Bok 227).