Introduction
Many times questions rise whether doctors should lie or tell the truth to their patients and families members. Issues regarding truth and lies affect people in all their communications processes. Doctors face the challenge of revealing the painful truth to patients almost every day of their professional lives. This was the case of Doctor Ivanitch. The doctor was attending to a young, beautiful girl, Alexandra who knew her death was imminent. However, the doctor assured everyone that the girl would survive (Turgenev 11).
In this case, there are disturbing and frequent lies that the doctor tells everyone. He lies to the patient, Alexandra’s mother, and probably to himself too. We may ask whether these lies were appropriate or beneficial or humane. This essay supports the idea that doctors should not tell lies to their patients, or family members even if they experience feelings of inadequacy as everyone else has unwavering belief in doctors.
The idea of not telling the patient the truth must a matter of great care. This is because patients may suffer much harm if doctors lie to them. When lying, doctors disregard the patient’s autonomy and at the same time, deny the patients opportunities of seeking alternative intervention.
Still, the patients lose all trusts in doctors. The issue of honesty is sufficient in a doctor-patient relationship. Moralists believe that patients need the truth because they are “ill, vulnerable, and worry about issues that require truthful answers” (Price 33).
The issue of honesty is fundamental in all medical issues. Doctors who suffer reputational loss due to lies end up losing their professions. We know that honesty is equally important for the patient and the doctor. However, most doctors have disregarded honesty in their profession.
Telling lies in the case of a doctor is wrong. However, only adequate justifications for such lies may sound morally acceptable. There are patients that have suicidal tendencies, irrational, and experience cases of severe depression. In addition, doctors may also lie to too pessimistic patients or when any unexpected results may worsen patients’ condition. In such situations, we may favor the doctor’s act of lying to the patient.
In modern days, it is not ethical to lie to patients in order to apply continued “intervention or cover up one’s own folly and for personal benefits” (Price 45). We must recognize that both revealing the truth and not disclosing the truth can do harm to the patient. In a clinical arena, telling the truth needs doctors to be sensitive, compassionate, intelligence, and comfort the patient in cases of negative reactions.
Unlike in the past where doctors were responsible for all aspects of communication with their patients, today, several other supporting professional have emerged to support doctors. These include social workers and nurses who can also reveal the truth to patients and their family members, and offers the necessary supports the patients and their family members may need. In some countries, patients have protections under the Patient’s Rights, which compel doctors to reveal the truth to their patients.
The Truth and Dying Patient
Patients would like to know the entire truth regarding their conditions. Thus, doctors may be wrong when not revealing such information. There are cases of patients who receive news of their imminent deaths and deny. This may warrant doctors to repeat such news till the patient comes to terms with reality.
When patients deny such news does not mean doctors are free to hold the truth from them. Patient must know the truth even if it is about their imminent death. People must face the reality and confront death. Thus, it is morally unjustified to assume that dying patients prefer moral superficiality. Death news may be painful, but most patients may feel relieved once they learn of their inevitable death.
Doctors, who do not disclose death news to their patients, subject such patients to painful experiences and cruel treatment. Patients who do not want to experience painful and suffering processes have resorted to an option of euthanasia. Consequently, this approach is gaining popularity in most countries.
Some patients have noticed that doctors will never reveal the truth to them. Thus, they will only die after suffering and when it is impossible to improve their conditions. However, knowing the truth can alleviate cases of loneliness, positive response to treatments and other intervention measures.
Conversely, telling the death news to patients may also result into harm (Greenberg 66). Therefore, doctors must prepare to guard against such negative encounters. This implies that doctors must learn how to tell the truth involving death. Telling the truth in a clinical context is right. However, doctors must review their patients’ medical conditions and negative personality traits before revealing death news. Still, patients need to know the truth even in cases of doubts.
There are also complex situations where it may be difficult to know a cover up or truthful disclosure. There may be justifiable reasons for not revealing the truth to the patient. However, cases of unjustified disclosures are inexcusable. In every situation, the truth will always come out. Thus, the need to tell the truth should guide doctors’ professional conducts and relationships with their patients.
Philosophical perspectives
According to Immanuel Kant, lying is moral unacceptable. Kant argued that people posses an innate intrinsic worth. This is what he referred to as human dignity. Human dignity recognizes the fact the people are rational, free to make their own choices, set their targets, and have control over their actions guided by reasoning. He further argued that human dignity means having “ethical requirements, ability to make free choices and respect the power within self and others” (Bailey 133).
Therefore, there are two reasons that make lies morally wrong. Lies undermine the fundamental quality of being a human. Lies do not give individuals chances of making rational and free choices. Thus, a lie denies people the experiences of self worth. Lies also deny others opportunities of making free and rational choices.
Lies make people base their decisions on untruthful disclosures that may be the opposite had they known the truth. This causes harm to human dignity and a sense of autonomy. We can only achieve ends if we value self and others. This is what Kant referred to as perfect duties. In this sense, there should be absolutely no lies.
Another perspective also posits that lying is wrong. This approach does not choose between right and wrong behavior, and what we should do or not do. Instead, it pays close attention to character development. It also looks at what an individual should be. Virtue approaches favor such arguments. People should possess attractive qualities that allow them to act in a given manner. Thus, being virtuous means a person must also be ethical (Bailey 130).
The complex nature of virtue ethics leaves little room for assessing people’s moral actions. In this respect, lying is morally wrong because it goes against the virtue of honesty (Price 41). However, critics question this view with regard to telling lies in order to pursue an important virtue. Virtue theorists have been able to overcome such criticism through the idea of unity of virtues. Virtuous persons strive to be ideal people.
Thus, when in conflicting positions between making a choice of compassionate lie and virtues, theory of virtue ethics posits that we should “imagine an ideal person would do in such situations and act according to the situation” (Bok 131). In this regard, an individual has the responsibility of making virtues his or her own, depending on his or her acts. In this case, lying becomes morally unacceptable act because it prevents people from becoming an ideal individual.
Another view of lies and ethics looks at benefits and harms associated with lying. According to utilitarian ethics, these can only be the two approaches to judge an action as a lie. These theorists believe that we can justify a lie when it allows us to derive maximum benefits and reduce chances of a greater harm.
Thus, the consequences of lying must maximize the benefits. Otherwise, it is immorally wrong to lie. Such an approach is difficult to use in making fundamental decisions of daily life. People who intend to lie must weigh the possible outcomes of their actions before lying. When a doctor has to lie, he should consider some facts (Bok 129).
The utilitarian perspective does not favor Doctor Ivanitch actions because there are maximum benefits his lies give the people. Instead, the doctor lies for his own selfish gain. Thus, he has not true intentions of lying.
There are also “noble lies or altruistic lies” (Revell 8). Such acts of lying usually benefit other individuals. Thus, utilitarians would find them acceptable. A doctor may tell a patient that there are hopes of recovery. However, the truth is that the patient will soon die as witnessed in the case of Doctor Ivanitch and Alexandra.
The only difference is that Alexandra is not a depressed patient and knows too well death is inevitable. However, when doctors confront cases of suicidal patients, then a lie may serve such patients in a better manner. Altruistic lie benefit the patient by avoiding the possible negative reactions the patient may take.
Such theoretical approaches are logical enough for warrant lies. However, critics of such theories note that we cannot use them in practical situations. This is because people underestimate or overestimate consequences of their actions, disregard their actions or harmful consequences. The flaw is in the ability of predicting the outcome of an action.
Doctors who lie undermine their patients trust in them. When people learn of such deceits, doctors suffer loss of values of trust, and their jobs too in some cases.
A decline in trust leads to cynicism, which in turn affects the quality of the patient’s life. Lies that people use in order to achieve maximum benefit may not yield the desired result as justifications for such actions have narrow applications, and often result from selfish motives.
Thus, doctors should lie in an attempt to stop an imagined denial, suicide or depression in patients. Most acts of lies lead to higher costs than the greater good lies pursue. Thus, we should not tolerate lies or subjective reasoning that attempt to justify acts of lying.
Another problem is that is it impossible to tell outcomes of lies. Thus, the idea that lies will bring great benefits should not be a basis for justifications of lies. In addition, we cannot tell whether lies will serve us right or not. Critics of such theories believe “lies have “lives of their own” and lead to results that individuals fail to plan for or predict” (Revell 8).
We can also note that being objective with regards to actions regarding lies are equally difficult. This is because people who lie mainly have vested interest they need to protect. Still, we can never have an accurate measure of the benefits or harm that lies can cause.
Conclusion
This essay has demonstrated that there are no moral grounds for doctors to engage in lies. In the past, doctors could get away with lies. However, in modern society, acts of lies have ruined some professions. It is now a major problem than in the previous decades.
Therefore, people should take perspectives of ethics before engaging in acts of lies. We must apply the value of ethical reasoning in determining right things to do. Doctors must recognize that information they give their patients will make differences in the patients’ attitude about illness, treatment, and the overall health. When we adopt different philosophical views, we end up with a mixed society that favors and opposes lies alike.
Works Cited
Bailey, Frederick George. The Prevalence of Deceit. Ithaca, NY: Cornell University Press, 1991. Print.
Bok, Sissela. Lying: Moral Choice in Public and Private Life. New York: Vintage Books, 1979. Print.
Greenberg, Michael. “The Consequences of Truth Telling.” The Journal of the American Medical Association, 266 (1991): 66. Print.
Price, Joan. Medieval and Modern Philosophy. New York, NY: Chelsea House, 2008. Print.
Revell, Jean-Francois. The Flight from Truth: The Reign of Deceit in the Age of Information. New York: Random House Books, 1992. Print.
Turgenev, Ivan S. The District Doctor and Other Stories of Turgenev. Emmaus, PA: Story Classics, 1951. Print.