“One of the most horrible things in a doctor’s work is telling bad news to patient. This is difficult both to a patient and doctor. This problem is very complex and considering it requires paying an attention on various factors. According to Ashley and O.Rourke in the past some doctors thought that the less patient knew about his condition, the better would be his chances for recovery (p. 187). It depends on patient how this information will be accepted, some people may accept their destiny, however other people may be heavily influenced and this influence can effect on their health and condition. Not less important is how doctor can tell this information, to do it in a right way; doctor has to be a great psychologist not to harm his patient. Doctors that work with cancer patients have to tell bad news several times in a month or even in a week. These doctors have huge mental pressure as it is very difficult to compassionate to every patient. Eventually this job becomes a routine and doctor has to have a strong psyche to hang in there and not to lose own humanity.
Positive effect which is called placebo depends on what patient knows about his disease. This effect is based on autosuggestion of patient, if person truly believes in curing, it may increase a chances that patient will be cured even if disease is bad. Experiments show that healing process depends on faith of the patients and telling a truth may have very bad consequences. Positive placebo responses are likely if patients have positive expectations about treatment (Shapiro, p. 226).
However, patient has a right to know about his physical state, he’ll get to know about it sooner or later, so there is no need in hiding the truth. Besides that doctors in many countries are obliged to tell truth to patients, otherwise doctor is breaking a law. So not telling the truth may result in a violation of the law. Doctor’s career depends on telling the truth to the patient and he has no choice and even if lie is better to patient, doctor has no legal right to hide the truth.
No one knows person better than relatives. In most cases it is recommended to consult with relatives before telling a painful truth to a patient. Relatives can help to find the best approach of telling bad news to a patient or they can insist on not telling anything about decease. The problem is that people are different, every person has own perception of bad information and it’s cannot be predicted whether this reaction will effect on patient’s condition in a positive or negative way. Ashley and O.Rourke thinks that patient should be given an accurate assessment of their condition (p. 186).
There are a few cases when death-sick patient become cured without any obvious reasons. Telling the truth to such patient can cause really bad consequences. Even if such person is cured a nervous system can be irreversibly damaged by telling bad news. However it is impossible to know whether patient will be cured or not as these cases are exceptions.
Considering all the facts there is no universal answer for this difficult question. Famous proverb says “Bitter truth is better than a sweet lying”, but sometimes truth is so bitter that no one can take it. Sooner or later patient will understand everything without any diagnosis and in some cases patient knows everything about own state as it is obvious. I think that there are more pros for telling the truth, as fatal diagnosis will be revealed sooner or later. If society wants to change such an order of things, first of all society has to convince government in adopting appropriate laws.
Grob, G. N. (2002). The Deadly Truth: A History of Disease in America: Harvard University Press.
Shapiro, A. K., & Shapiro, E. (2010). The Powerful Placebo: From Ancient Priest to Modern Physician: Johns Hopkins University Press.
Ashley, B. M., & O’Rourke, K. D. (2002). Ethics of Health Care: An Introductory Textbook: Georgetown University Press.“
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