Trust is one of the vital elements in the building of relationships between the doctor and the patient. If trust is absent, the whole treatment can lead to worse than desired outcomes. It is safe to assume that the creation of trust requires honesty from both sides, so the doctor should always be honest with their patient. However, certain situations or kinds of patients can create an ethical dilemma, in which honesty does not always seem the best approach (Nierengarten, 2019). Telling the truth to patients with self-harm potential can cause them to commit dangerous actions against themselves, for example, driving them to suicide attempts after being diagnosed with severe disease.
Daniel K. Sokol developed a special deception flowchart designed to help medical personnel in morally complicated circumstances. Instead of frantically choosing between hard truth and potentially helpful lies, a physician can address to algorithm and carefully evaluate their options in any particular situation. They can weigh justifications of deception against possible consequences and make a reasonable decision. According to the flowchart, the final decision in favor of deception should be made if a reasonable patient would agree with deception while being aware of it (Nierengarten, 2019). In the case of patients with a self-harm potential, this flowchart can convince the doctor to use a benevolent deception since self-harming tendencies are not reasonable. Therefore, the doctor would be making a decision that suits the patient’s interest the best, while the truth could be harmful both ethically and medically.
However, deception should remain an option only for the highly demanding interactions, even for the most demanding of them. The sheer number of questions and considerations in the deception flowchart implies that benevolent lies and omissions should be the last resort in dealings with the most challenging patients. Therefore, while courage can be a saving grace, it cannot trump honesty, trust, and mutually open dialogue between the doctor and the patient.
References
Nierengarten, M. B. (2019). Pediatric truth-telling: omission vs deception. Contemporary Pediatrics, 36(4), 24-33.