Veracity to Patients

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Therapeutic privilege involves the deception of patients by their doctors. If a doctor feels that pertinent information may potentially do more harm to the patient than good, he may withhold that information. It was once widely believed that if a terminal patient found out he/she were going to die, the information would ultimately cause him/her more harm and anguish. To “protect” their patients, doctors often withheld such information. Grounds for this justification are in the principles of beneficence and nonmaleficence.
Therapeutic privilege is no longer deemed ethical as it disregards the moral principle respect for autonomy. For a patient to be able to act autonomously, the patient must possess a certain amount of knowledge regarding his/her healthcare. Doctors that engage in therapeutic privilege and withhold relevant information are not granting their patient the right to make autonomous choices regarding his/her prognosis or treatment options. This violates informed consent, in which the patient is adequately informed and granted disclosure.
Case #17-1 Therapeutic Privilege: Scaring the Patient to Death with News about Risks provides a good example of why some physicians choose to omit getting a patients consent for certain procedures. Dr. Therapides suspects that her patient has a block in his abdominal aorta and knows that to locate it she must inject the patient with sodium urokon. She is also aware that the procedures has risks and in some cases results in paralysis or even death. Yet, Dr. Therapides feels that the patient, who is already frightened and apprehensive, may become more apprehensive if he is aware of the risks associated with the procedure. Dr. Therapides believes that she should be granted therapeutic p...

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...decision. While Dr. Therapides may feel that her patient will become more frightened after hearing about the risks associated with the procedure, I still feel that it is her duty to inform him.
The patient may not ever be “fully informed” but, the pertinent information in this case must be disclosed if Dr. Therapides plans to follow protocol. In following the elements of consent, she must make sure that her patient has the capacity to make a decision in his healthcare and voluntarily agrees to do the surgery. Dr. Therapides must also disclose the possible risks and benefits of the treatment options and give her professional recommendation. Lastly, Dr. Therapides should make sure that her patient understands what the options are in regards to his treatment, diagnosis, and prognosis, and is able to make a decision and either authorize or refuse the recommendation.
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