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Professional ethics of medicine
Truth telling in healthcare
Ethics in the medical field
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There are a lot of moral problems in healthcare, one being truth-telling. It is highly believed that a doctor should tell his patient the truth, in order to respect the autonomy of the patient. However aren’t there some cases where telling the truth can proved to be harmful? Can we conceive a world where lying is not permitted? A study of Immanuel Kant’s arguments on truth-telling in general, then an analysis of Joseph Collin’s ideas on truth-telling in healthcare might help us have a better understanding of the different questions that emerge from this problem.
Kant defends the principle that we should never lie, even if our doing so could prevent a death. He believes the expression “to have a right to the truth” to have no meaning and argues that people should rather say that a man has a right to his own truthfulness (603). For him, truth in utterances that cannot be avoided is the formal duty of a man no matter how bad are the consequences (603). According to him, what the jurists believe to be a lie, that is an intentionally false declaration towards another man that must hurt another, is not proper because a lie always injures another (604). He thinks that whoever tells a lie, however good his intentions are, is responsible for the consequences and must pay the penalty (604). He argues that to be truthful in all declarations is a “sacred unconditional command of reason” (604).
In contrast, Joseph Collins takes a different view in his presentation. He chooses a negative answer to the question “Should doctors tell patients the truth”. He thinks that telling the whole truth is often perpetrating a cruelty of which many are incapable (605). He divides patients in four categories of people: those who want to know the tr...
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...ins try to be more realistic and talk about what their experiences are. For Kant, lying is always wrong whereas Collins thinks that lying contribute to the success of the physician’s job. Kant is stricter on the subject. However, Collins’ perception of the subject might be more appealing to people because he involves the reader. Doctors focus on the well-being of patients and if they think not telling the whole truth is helping them, it should not be considered wrong.
Works Cited
W. Chen, Pauline. “When Doctors Don’t Tell the Truth”. The New York Times. New York Times, 01 March 2012. Web. 22 April 2014.
Collins, Joseph. “Should Doctors Tell the Truth?” Kuhse and Singer 605-610
Kant, Immanuel. “On a Supposed Right to Lie from Altruistic Motives”. Kuhse and Singer 603-604
Kuhse, Helga, and Peter Singer, eds. Bioethics an Anthology, Malden: Blackwell. 2006. Print
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
Collins argument was for doctors to act in paternalistic lies. Paternalistic lies are lies that are told in someone best interest. A lot of times this act occurs between parents and children. The fact of the matter is this applies in the same way. As a medical professional doctors are believed to be in the right almost all the time, which is why patient try to follow doctors advice. In Lying and lies to the Sick and Dying by Sissla Bok, Bok argues it is not all right to lie
Fan, Ruiping, and Benfu Li. "Truth telling in medicine: the Confucian view." The Journal of medicine and philosophy 29.2 (2004): 179-193.
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).
The question of what constitutes morality is often asked by philosophers. One might wonder why morality is so important, or why many of us trouble ourselves over determining which actions are moral actions. Mill has given an account of the driving force behind our questionings of morality. He calls this driving force “Conscience,” and from this “mass of feeling which must be broken through in order to do what violates our standard of right,” we have derived our concept of morality (Mill 496). Some people may practice moral thought more often than others, and some people may give no thought to morality at all. However, morality is nevertheless a possibility of human nature, and a very important one. We each have our standards of right and wrong, and through the reasoning of individuals, these standards have helped to govern and shape human interactions to what it is today. No other beings except “rational beings,” as Kant calls us, are able to support this higher capability of reason; therefore, it is important for us to consider cases in which this capability is threatened. Such a case is lying. At first, it seems that lying should not be morally permissible, but the moral theories of Kant and Mill have answered both yes and no on this issue. Furthermore, it is difficult to decide which moral theory provides a better approach to this issue. In this paper, we will first walk through the principles of each moral theory, and then we will consider an example that will explore the strengths and weaknesses of each theory.
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.
Rhodes, R. and Strain, J.J. (2004) Whistleblowing in academic Medicine. Journal of Medical Ethics. 30 (1)
Almost doctors and physicians in the world have worked at a hospital, so they must know many patients’ circumstances. They have to do many medical treatments when the patients come to the emergency room. It looks like horror films with many torture scenes, and the patients have to pay for their pains. The doctors have to give the decisions for every circumstance, so they are very stressful. They just want to die instead of suffering those medical treatments. In that time, the patients’ family just believes in the doctors and tells them to do whatever they can, but the doctors just do something that 's possible. Almost patients have died after that expensive medical treatments, but the doctors still do those medical procedures. That doctors did not have enough confidence to tell the truth to the patients’ families. Other doctors have more confidence, so they explain the health condition to the patients’ families. One time, the author could not save his patient, and the patient had found another doctor to help her. That doctor decided to cut her legs, but the patient still died in fourteen days
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...
Kant, Immanuel. Grounding for the Metaphysics of Morals: With on a Supposed Right to Lie Because of Philanthropic Concerns. Trans. James W. Ellington. Indianapolis: Hackett, 1994. Print.
When one initially chooses a career path, one rarely looks at all the negatives that may be associated with that choice. Most career paths have some negatives associated with the field, but few face the moral dilemmas associated with modern healthcare. Those who choose to be in the healthcare profession today are faced with moral and ethical dilemmas that would make King Solomon tear his hair out. In many cases, doctors, and sometimes nurses, are faced with life and death decisions without the benefit of knowing the patient’s, or the patient’s family’s, wishes. However, aside from those tragic times when a patient’s wishes are unknown, healthcare professionals must always put their own morals aside, and act
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.
Kant’s chief argument is telling the truth is paramount, when speaking: “Truthfulness in statements which cannot be avoided is the formal duty of an individual...however great...the disadvantage accruing to himself or to another.” Lies, Kant claims, always hurt people, violating the duty of truth, so telling them, even to protect another, harms mankind. He gives the example of telling a murderer searching for your friend they have left, if the friend is there: you should tell the murderer the truth, because if you do not, you are responsible for the consequences. If you tell the truth, law cannot hold you accountable for the friend’s murder, but if you lie, and the friend dies, you can be considered the cause of death, because your lie lead to their death.
In an excerpt by Sissela Bok, Rejecting All Lies : Immanuel Kant, Bok explains Kant’s argument that lying is a given right to another person. In the excerpt it argues that ,“Truthfulness in statements which cannot be avoided is the formal duty of an individual to everyone, however great may be the disadvantage.” Many people lie to avoid a disadvantage for themselves but Kant has a different view. Basically what Immanuel Kant is saying the truth should always be told no matter what situation or how big the conscience. This is because it is our duty to proved the truth to