Practice of Deception: Critically Ill Patients

The duty to do no harm plays, beyond any doubt, a major role in regard to codes of ethics in medicine. Some health care professionals practice this duty through a teleological approach of ethics, where “one should always act in such a way as to maximize the balance of good over harm for the greatest number of people.” The doctor’s highest moral engagement is, above all, to help and not to harm the patient. This value is so reinforced that lying to avoid harm is acknowledge as acceptable, especially in lethal condition cases. Because of this focus on the do no harm duty and since telling the truth about critical illnesses is presumed to induce harm to the victim, some physicians deceive their patients by withholding information or by telling them plain lies. This type of physician-patient relationship depicts the paternalistic approach, where the physician does what he thinks is best for the patient without even asking for opinion or consent. Can this really be the most beneficial way to deal with difficult prognosis?

It has been suggested that using deception in the case of patients diagnosed with lethal conditions is morally right and preferred to telling the truth considering that patients can’t understand their conditions and no one wants to hear bad news anyway. This paper will critically assess the practice of deception towards critically ill patients and argue against the views of its defenders while proposing a physician-patient relationship based on honesty and the duty to tell the truth even when faced with a fatal prognostic. It will also demonstrate that patients can clearly assimilate medical information about their condition if they are well informed by their physicians. Also, even though nobody wants to hear dreadful news, people usually care about knowing what is wrong with them. Isn’t that why they seek medical consultation in the first place? I will start by clarifying the different ways of interpreting the duty to do no harm and the duty to tell...