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Hippocratic oath and the ethics of medicine
The Hippocratic Oath
Words to the hippocratic oath
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Roger Higgs, in “On Telling Patients the Truth” supplies commonly used arguments for paternalistic deception. For the purposes of this paper, paternalism will be defined as, “interference with one’s autonomy or self determination for their own good.” The first argument for paternalistic deception is founded on the idea that medicine is a technical subject where there are very few guarantees (613). Thus, Higgs supplies the argument that not only is it impossible for a patient to understand the true breadth of their diagnosis and prognosis, but additionally that medical predictions are not medical truths. The second argument for paternalistic deception comes from the belief that patients do not actually want to know the truth about their condition, and could suffer from worse health outcomes if they are told the truth (614, 615).
In “Should Doctors Tell the Truth?” Joseph Collins argues for paternalistic deception, declaring that it is permissible for physicians to deceive their patients when it is in their best interests. Collins considers his argument from a “pragmatic” standpoint, rather than a moral one, and uses his experience with the sick to justify paternalistic deception. Collins argues that in his years of practicing, he has encountered four types of patients who want to know the truth: those that want to know so they know how much time they have left, those who do not want to know and may suffer if told the truth, those who are incapable of hearing the truth, and those who do not have a serious diagnosis (605). Collins follows with the assertion that the more serious the condition is, the less likely the patient is to seek information about their health (606).
Collins argues that doctors should frequently withhold ...
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However, it has been reported that telling a patient the truth may significantly improve their wellbeing as they approach the end of their life. One study revealed that truth telling may reduce terminal cancer patients’ uncertainty and anxiety, as indicated by lower scores on a Hospital Anxiety and Depression scale, and higher scores on a Spiritual Well-being scale (Kao et al. 2013). Furthermore, while there is no explicit principle regarding lying within the Hippocratic Oath, honesty is a virtue that is closely associated with physicians and health care providers. In fact, honesty can be closely related to respect for persons, which implies that it is necessary for the maintenance of the physician-patient relationship. Honesty about all relevant aspects of a patient’s diagnosis, prognosis and treatment are necessary to build trust, and to obtain informed consent.
Cullen and Klein understand that deception is wrong and disrespectful to the patient but criticize that some cases are more complicated and not so black and white. They argue that physicians should be able to withhold information that can significantly benefit the patient. The key part is that the benefit is greater than what the deception causes.
One of the most complex, ever-changing careers is the medical field. Physicians are not only faced with medical challenges, but also with ethical ones. In “Respect for Patients, Physicians, and the Truth”, by Susan Cullen and Margaret Klein, they discuss to great extent the complicated dilemmas physicians encounter during their practice. In their publication, Cullen and Klein discuss the pros and cons of disclosing the medical diagnosis (identifying the nature or cause of the disease), and the prognosis (the end result after treating the condition). But this subject is not easily regulated nor are there guidelines to follow. One example that clearly illustrates the ambiguity of the subject is when a patient is diagnosed with a serious, life-threatening
After reading Should Doctors Tell the Truth by Joseph Collins, I started steer away from Collins views. I disagree with Collins thesis because it isn’t permissible to take control of anyone’s autonomy whether or not it’s in his or her best interest.
The nurse should not inform the patient of her leukemia. The nurse has not been observing the patient long enough to use her assumption that the patient is mentally sound as a means to justify telling the patient stressful information. The nurse ought to follow the physicians instruction to refrain from giving the patient news about their chronic lymphocytic leukemia. This resolution follows with my own moral intuitions. If someone is not in a healthy mental state, it would not be morally permissible to provide information to that person which could cause their mental state to worsen. Although in most cases it is obligatory for a moral agent to always tell the whole truth in accordance with the prima facie principle of honesty, the principle of beneficence in moral situations similar to this one overrides the principle of honesty. One’s own health and well-being is more important than answering their questions to the fullest knowledge
Truth in medicine is a big discussion among many medical professionals about how doctors handle the truth. Truth to a patient can be presented in many ways and different doctors have different ways of handling it. Many often believe that patient’s being fully aware of their health; such as a bad diagnosis, could lead to depression compared to not knowing the diagnosis. In today’s society doctor’s are expected to deliver patient’s the whole truth in order for patients to actively make their own health decisions. Shelly K. Schwartz discusses the truth in her essay, Is It Ever Ok to Lie to Patients?. Schwartz argument is that patients should be told the truth about their health and presented and addressed in a way most comfortable to the patient.
In my own personal story, I truly appreciated the doctor telling me that it would be painful. Also, in I Am Not a Patella, I felt as though the doctor was not honest by not telling the patient anything about her condition. According to Arnold and Boggs, “honesty is a basic building block in establishing trust. Studies show that clients…prefer complete disclosure” (pg. 205). The client is in an extremely vulnerable position. It is extremely important that the nurse or other health care provider be sensitive to this and ensure that trust is maintained. (College of Nurses of Ontario, 2013). Those who are terminally ill, appreciate those professional who are willing to talk to them honestly about dying and end of life preparations (Terminally Ill Deserve Honesty,
End-of-life care in the United States is often fraught with difficult decisions and borne with great expense. Americans are often uncomfortable discussing death and
First of all, if the physician is talking with a middle-aged man about his state of health before talking with his family, the patient might result in depression, can regret or even feel the need to give up treatment. If the doctor is talking with an elderly patient about his or her condition, it is likely that the older patient will choose not to pursue the treatment because his or her life is lived and there is no purpose to agonize and hurt relatives in the process of treatment. A possible exception is if a doctor’s patient is a child. For a doctor, it is not necessarily important to be completely honest directly with the young patient without talking with family first. This is mainly because the child is not very educated to understand the severity of their condition or the potential outcomes. In addition, the child cannot make decisions independently. It is important for a physician to talk with a child’s parents or guardians prior to discussing the child’s condition with the child itself. This allows the physician be certain that after a diagnosis, the child will be less likely to be psychologically traumatized. ...
From the utilitarian’s side, lying might be a good choice, since it brings more happiness to the patient. In fact, truthfulness can actually do harm. Patient’s health situation becomes worst when he knows that he have a serious disease. He will become depressed and might suffer from psychological disorders like anxiety which reduces the efficiency of healing. For example people suffering from Nosophobia , Hypochondriasis or Nosocomephobia: “which are an irrational fear of contracting a disease, a fear of hospitals or refers to excessive preoccupancy or worry about having a serious illness ” are most likely to be affected by truth of having a serious ill or undergoing a dangerous medical operation. That’s why some doctors use lying as way of curing; they don’t try only to heal the disease, but also they make sure that the patient is in his most relaxed state, in order not to harm him. Roger Higgs in his article “On telling patients the truth” argues that doctors have no exemption from telling the truth. I other words, when a doctor lies he needs to give justifications. For the maleficence argument, Higgs argues that the truth actually does not harm; but the way the doctor tells the truth a...
One day while doing his job, a physician used a used swab that was possibly infected with HIV on another patient. When looked at by certain people, the doctor did the correct thing by telling his patient that he roused a swab on him/her. However, the chances of this patient getting HIV was substantially low, and he should have waited for the patient to develop symptoms, which would have been rare, before telling the truth. As stated by Michael Greenberg, “he might have done better by keeping his mouth shut.” If the doctor did lie, he could have lied to protect himself, the quality of life of the patient, and his ability to help others with their lives. If he had not told the patient that he used the swab on him/her, he/she would not have had to live in fear of getting HIV. Because of this decision of truth telling, the doctor lost his job, money, confidence, and also affected someone’s quality of life.
The most common areas of clinical practice where truth-telling and deception become an ethical dilemma are critical care, cancer and palliative care, mental health and general nursing practice (Tuckett, 2004). Other areas where it can raise potential ethical concerns are in placebo therapy, disclosure of human immunodeficiency virus and informed consent (Tuckett, 2004). Truth-telling is also an act of exchanging moral agents (patients, relatives, nurses) with their sets of values and norms, which in turn are derived from culture, personal and religious beliefs, and traditions (Dossa, 2010). For this reason, the issue of truth-telling is not only approached differently in the various clinical settings but also in different countries, cultures and religions (Kazdaglis et al., 2010). For example, in the United States of America (USA), England, Canada and Finland, the majority of patients are told of their diagnosis (Kazdaglis et al., 2010). Conversely, in Japan, family members play a major role in the decision of ...
The writer discusses a situation of the doctor failing to disclose the nature of important medical condition which can jeopardize several of the patient’s family members and puts the doctor at odds with them. The problem is also discussed by Sutrop (2011) who show how protecting the patient’s confidentiality and self- decision capacity has actually caused severe hindrances to the field of scientific development and research.
In simple terms, truth telling is about being honest with patients. This means telling patients about their diagnoses, treatments and other medical information completely. Ideally health professionals would always be able to do so, but there are times where it may be best to be untruthful rather. In some cultures for instance, serious diagnoses are typically hidden from patients because of how damaging they can be to patients. Complicating this, untruthfulness comes in various degrees (Lo, 1995), so doctors must discern the level of untruthfulness appropriate for a given situation.
Bakhurst, David. “Lying and Decieving.” Journal of Medical Ethics 18 (June 1992): n. pag. JSTOR. Web. 29 Sept. 2011.
Consequently, it can be assumed that doctors might tend to avoid such a confession in order to maintain their image of being a “good doctor” (J.Shahidi). Not being a good doctor may eventually lead to doctor’s loss of business and as a result physicians may tend to hide the truth even if it opposes patient autonomy