Truth-telling versus Deception

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Healthcare professions have codes of conduct and ethics that address the issue of honesty and trust in relation to patient encounters yet truth-telling (or being honest) versus deception (or being dishonest) has been identified as an ethical issue in hospitals, particularly about diagnosis and prognosis disclosures. Dossa (2010) defines being honest or telling the truth as relating the facts as one knows them. Furthermore, Dossa (2010) states that deception can be an act of dishonesty but also can be without lies. In other words, forms of deception include not giving any information, not giving information of the truth, withholding information, selecting what information to give and not give, and giving vague information.
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 ...

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