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Hippocratic oath and the ethics of medicine
The Hippocratic Oath
Words to the hippocratic oath
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Roger Higgs, in “On Telling Patients the Truth” supplies commonly used arguments for paternalistic deception. For the purposes of this paper, paternalism will be defined as, “interference with one’s autonomy or self determination for their own good.” The first argument for paternalistic deception is founded on the idea that medicine is a technical subject where there are very few guarantees (613). Thus, Higgs supplies the argument that not only is it impossible for a patient to understand the true breadth of their diagnosis and prognosis, but additionally that medical predictions are not medical truths. The second argument for paternalistic deception comes from the belief that patients do not actually want to know the truth about their condition, and could suffer from worse health outcomes if they are told the truth (614, 615).
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).
Collins argues that doctors should frequently withhold ...
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However, it has been reported that telling a patient the truth may significantly improve their wellbeing as they approach the end of their life. One study revealed that truth telling may reduce terminal cancer patients’ uncertainty and anxiety, as indicated by lower scores on a Hospital Anxiety and Depression scale, and higher scores on a Spiritual Well-being scale (Kao et al. 2013). Furthermore, while there is no explicit principle regarding lying within the Hippocratic Oath, honesty is a virtue that is closely associated with physicians and health care providers. In fact, honesty can be closely related to respect for persons, which implies that it is necessary for the maintenance of the physician-patient relationship. Honesty about all relevant aspects of a patient’s diagnosis, prognosis and treatment are necessary to build trust, and to obtain informed consent.
When it comes to a bad diagnosis it is often difficult for doctors to tell their patients this devastating news. The doctor will likely hold back from telling the patient the whole truth about their health because they believe the patient will become depressed. However, Schwartz argues that telling the patient the whole truth about their illness will cause depression and anxiety, but rather telling the patient the whole truth will empower and motivate the patient to make the most of their days. Many doctors will often also prescribe or offer treatment that will likely not help their health, but the doctors do so to make patients feel as though their may be a solution to the problem as they are unaware to the limited number of days they may have left. In comparison, people who are aware there is no cure to their diagnosis and many choose to live their last days not in the hospital or pain free from medications without a treatment holding them back. They can choose to live their last days with their family and will have more time and awareness to handle a will. Schwartz argues the importance of telling patients the truth about their diagnosis and communicating the person’s likely amount of time left as it will affect how the patient chooses to live their limited
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 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.
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
After reading Should Doctors Tell the Truth by Joseph Collins, I started steer away from Collins views. I disagree with Collins thesis because it isn’t permissible to take control of anyone’s autonomy whether or not it’s in his or her best interest.
The nurse should not inform the patient of her leukemia. The nurse has not been observing the patient long enough to use her assumption that the patient is mentally sound as a means to justify telling the patient stressful information. The nurse ought to follow the physicians instruction to refrain from giving the patient news about their chronic lymphocytic leukemia. This resolution follows with my own moral intuitions. If someone is not in a healthy mental state, it would not be morally permissible to provide information to that person which could cause their mental state to worsen. Although in most cases it is obligatory for a moral agent to always tell the whole truth in accordance with the prima facie principle of honesty, the principle of beneficence in moral situations similar to this one overrides the principle of honesty. One’s own health and well-being is more important than answering their questions to the fullest knowledge
In my own personal story, I truly appreciated the doctor telling me that it would be painful. Also, in I Am Not a Patella, I felt as though the doctor was not honest by not telling the patient anything about her condition. According to Arnold and Boggs, “honesty is a basic building block in establishing trust. Studies show that clients…prefer complete disclosure” (pg. 205). The client is in an extremely vulnerable position. It is extremely important that the nurse or other health care provider be sensitive to this and ensure that trust is maintained. (College of Nurses of Ontario, 2013). Those who are terminally ill, appreciate those professional who are willing to talk to them honestly about dying and end of life preparations (Terminally Ill Deserve Honesty,
First of all, if the physician is talking with a middle-aged man about his state of health before talking with his family, the patient might result in depression, can regret or even feel the need to give up treatment. If the doctor is talking with an elderly patient about his or her condition, it is likely that the older patient will choose not to pursue the treatment because his or her life is lived and there is no purpose to agonize and hurt relatives in the process of treatment. A possible exception is if a doctor’s patient is a child. For a doctor, it is not necessarily important to be completely honest directly with the young patient without talking with family first. This is mainly because the child is not very educated to understand the severity of their condition or the potential outcomes. In addition, the child cannot make decisions independently. It is important for a physician to talk with a child’s parents or guardians prior to discussing the child’s condition with the child itself. This allows the physician be certain that after a diagnosis, the child will be less likely to be psychologically traumatized. ...
End-of-life care in the United States is often fraught with difficult decisions and borne with great expense. Americans are often uncomfortable discussing death and
Should doctors tell the truth to their patients? How much information should the patient know about a certain ill or operation? These controversial questions are asked more frequently in our society. Patients nowadays,. are very sensitive to certain diseases more than before. This paper argues against telling the truth in doctor-patient relationship. Not by defending the idea directly but, by presenting first how truth can be harmful to the patient and by giving Higgs’ objection to it, then by giving my own objection to Higgs’ argument.
In simple terms, truth telling is about being honest with patients. This means telling patients about their diagnoses, treatments and other medical information completely. Ideally health professionals would always be able to do so, but there are times where it may be best to be untruthful rather. In some cultures for instance, serious diagnoses are typically hidden from patients because of how damaging they can be to patients. Complicating this, untruthfulness comes in various degrees (Lo, 1995), so doctors must discern the level of untruthfulness appropriate for a given situation.
Papadopoulos, O. (2010). Disclosing the truth to terminal cancer patients: a discussion of ethical and cultural issues. Eastern Mediterranean Health Journal, 16(4), 442-447.
Bakhurst, David. “Lying and Decieving.” Journal of Medical Ethics 18 (June 1992): n. pag. JSTOR. Web. 29 Sept. 2011.
The specific issue in questions is whether a nurse should keep the truth from their patient about their illness by respecting the wishes of the patient family or abiding by The Code of Ethics for Nurses and revealing the truth to the patient. The Code of Ethics for Nurses expresses the values and ethics of the nursing profession by stating that: Patients have the moral and legal right to determine what will be done with their own person; to be given accurate, complete, and understandable information in a manner that facilitates an informed judgment; to be assisted with weighing the benefits, burdens, and available options in their treatment, including the choice of no treatment; to accept, refuse, or terminate treatment without deceit, undue influence, pressure, intimidation, or penalty; and to be given necessary support throughout the decision-making and treatment process (The American Nurses Association, 2011). Unfortunately, truth telling to any type of patient is a common ethical dilemma: to tell the truth or to not tell the truth is the main question. Nurses have the closet relationship with patients and therefore are the ones put in a difficulty situation between their patient and the patient’s family. Who should they satisfy? Should they leave their patient in the
The writer discusses a situation of the doctor failing to disclose the nature of important medical condition which can jeopardize several of the patient’s family members and puts the doctor at odds with them. The problem is also discussed by Sutrop (2011) who show how protecting the patient’s confidentiality and self- decision capacity has actually caused severe hindrances to the field of scientific development and research.