TRUTH-TELLING 2 The Importance of Truth-Telling Telling the truth is something that comes up for the majority of us in childhood. It is considered impolite to lie and when a lie was told, or you were untruthful, it was often considered a reflection of your parents’ moral attitudes. Unfortunately, we all seem to have been taught differently the exact nature of a truth or lie and the right or wrong way to use that information. In To Lie or Not to Lie? – The Doctor’s Dilemma (2007), the topic of truth versus lies by doctors specifically, is discussed.
While I believe it is important for doctors to be truthful in their dealings with patients, the 5 W’s need to be explored: what and to whom is truth, how and when are doctors choices for truth-telling determined and why it is important for them to tell the truth to their patients. Truth: “conformity to fact or reality” according to the Canadian Oxford Dictionary, does not appear in society to be that concrete. From childhood we were taught about the importance of truth with the consequences of our actions meted out if we were not truthful.
Often our understanding of this subject was not the same as ”Johnny’s” next door and we were left with this confusing amalgamation, forced to gage for ourselves on a situational basis how much was lie or truth in any given statement. Society’s opinion on this topic therefore is varied based on our own individual ethics developed over the years. Doctors, held to far higher standards than the rest of us, are forced to play ‘God’ with their patients, although the Uncertainty principle “suggests that there is no certainty in health care, therefore no ‘absolute truth’ to reveal. Truth-telling can never be achieved. ” (Tuckett, 2004, p. 500). In his determinations a doctor “must be careful to distinguish the notion of ‘truth’ as ‘the way things really are’ (so-called objective truth) from that of ‘truth’ as ‘the way a person believes things to be’. ” (Tuckett, 2004, p. 508). TRUTH-TELLING 3 The Importance of Truth-Telling The American College of Physicians Ethics Manual influences decision making by doctors via principles. Although these principles “do not provide ordered rules, these principles can help doctors and other health care workers to ake decisions when reflecting on moral issues that arise at work. ” (Gillon, 1994, p. 184). Respect for Autonomy, one of these guiding principles used in most of the decisions with long term disabilities or terminal illnesses, acknowledges a “persons right to hold views, to make choices” and to take actions…” (Shahidi, 2010, p. 590). Medical Ethics are in place to create a balance between all versions of ‘truth’ and provide structure for the relationship between doctor and patient, as well to provide guidance for the doctor and protect the rights of the patient.
Because truth is not black and white like we sometimes wish to think the doctor can use this framework to foster an honest and trusting relationship with his patients. The consequences can be long lasting if the truth is not told to patients in a timely fashion or in its entirety. Illness can get away from you quickly with no chance to turn back the clock or simply the chance to make amends to facilitate a peaceful exit. Doctors deceiving patients, whether by omission or by using semi-truths, erodes trust in that relationship (Tuckett, 2004).
By not being honest with a patient diagnosis they may cause the patient undue hardship as according to Mitchell, ”Patients with false information or no information about their condition may unintentionally mislead other physicians involved in their treatment” (Shahidi, 2010, p. 592). Lying also strips “the patient’s ability to be autonomous and fails to show respect for persons. ” While “truth-telling maintains the competent patient’s status as an adult”. (Tuckett, 2004, p. 505). TRUTH-TELLING 4 The Importance of Truth-Telling
Maintaining the patients welfare should be the primary goal of a doctor while he is determining exactly just how to address the truth-telling. One of the principles under medical ethics is ’above all do no harm’. The long lasting consequences of choosing which ‘truth’ to tell could call into question this principle. We have determined that truth is not as cut and dried as we would like it to be, but there still needs to be a focus on honesty, truthfulness, and full disclosure with doctors and their patients.
Our health is a joint effort, and we need to be able to rely on and trust our medical professionals to let us know what really is happening. I believe that the least amount of harm in the long run would be in telling the complete truth, however I understand that we are all different and our situations are different and it then stands to reason that the solutions will all be different as well. By keeping in mind the who, what, where, when, why and even how, I think the acquisition of this information would give the best answer to each truth-telling situation.