Medical Ethics -Should Doctors Tell Their Patients the Truth?

With regards to the issue of whether doctors should tell the truth to their patients, the AMA's Principles of Medical Ethivs state, "A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights (AMA). This effectively states that doctors, indeed, shall tell the turht. However, in the advancing filed of medical ethics, the issue become the timing of telling the truth, how to best tell the truth, how much truth to tell, and who decides these issues and many more.

As society advances in terms of science and medicine, the line between the truth and a lie really begins to blur and blend. Is withholding part of the turh a lie? What is the patient could be harmed by the information? Should the doctor still tell the truth? What if the patient is too ill to understand the information? Does the doctor still tell the patient? Who else does he/she tell? Who makes the decision about treatment? How are these issues decided and many more. If doctors tell the turht in certain situations, they may actually harm their patients. However, if they do not tell the turh, the patient's trust in the doctor and the entire medical profession can be eroded. There are two schools of camp-one that believes doctors are acting within the best limits of their profession and one who feels that doctors are making too many decision for patients.

Personally, I will always favor truth. However, as Dr. James F. Drane says: "To tell the truth in the clinical context requires compassion, intelligence, sensitivity, and a commitment to stay with the patient after the truth has been revealed" (Drane). The demands for doctors are becoming more and more, but they really should not be doctors if they cannot commit to the above quote. However, the problem of how much truth to tell and when to tell it comes into play. If a patient is clinically depressed and/or suicidal, should a doctor fully disclose something catastrophic? This could cause someone to do themselves bodily harm. People need the truth in order to be able to make educated decisions about their own health. However, many people would prefer a more compassionate approach than brutal full disclosure. "Telling the truth in a clinical context is an ethical obligation but determining just what constitutes the truth remains a clinical judgment" (Dranee )

And this is exactly the case when it comes to Monrica. She has no good option to make regarding her medical care. Waking her up to offer her a no-win choice seems cruel and inhumane to doctors and nurses. Waking her up will cause her pain and suffering, and her condition is bad enough that she will not recover. Her life expectancy is short, and even if they wake her, the pain and discomfort might be so great that she will not be able to make the decision. Given her health problems, she may not be able to think rationally about what choice to make. As the text pointed out, the decision is also hard for family members and such because their main concern is only to shield the patient from more pain. Monica would not be able to ask for dangerours treatment, thereby endangering herself with the decision. But there is no good decision. Basically the question comes down to not waking Monica up and taking no heroic measures to keep her alive or waking her up to tell her, thereby causing her pain and the mental anguish of making a decision that won't save her life anyway. This is a terrible decision for the medical profession, but decisions of this type happen more often than we think.

In this situation, my first response would be to say that if Monica wakes up on her own, she should surely be informed of her situation, no matter how painful that is for her. She has a right to know, to be informed of her choices, and to make an informed decision. However, I don't believe the doctors should wake her up. If she stays in a coma and drifts off into death, this is the best option for her. Some would argue that the doctors are acting "patriarchally" for her, trying to make her decisions for her. I would argue that they are being humane. If the tumor were operable or there were any other way for her to recover from this episode, then my answer would be completely different. This is not the the case with Monica. The doctors are not participating or even suggesting assisted

suicide or anything like that. They can simply choose not to wake her up.

With medical advances happening at lightening speed, choices like this will become more and more common. Truth is always the best option, but waking someone up to tell him/her that he/she is dying and that death will happen quickly seems inhumane to me. No matter that they are in some ways making the decision for her, they should also be shielding her from the pain of her choices by not waking her up.