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But at every step, as the proverb says, she weaves a still more tangled web, drawing others (nurses and technicians) into a complex deception.The chances of the truth being discovered are always greater. B will probably find out that he was lied to, and that will make it harder for him to trust his doctor.
Only then can the patient relax and stop being wary, stop the constant effort to scrutinize the doctors words for what might lie behind them.
Finally, there is the matter of the physician's own integrity. 60ff) Integrity is a matter of connection and integration between the parts of our lives: in this case, between the doctors words and her beliefs.
Thirdly, the doctor patient relationship depends upon trust.
It is very difficult to trust someone after we discover they have lied to us. B now, but the truth will come out sooner or later.. B will develop symptoms, will return to the doctor, and the doctor will need no tests in order to tell him what is wrong.
But the trust that is necessary in a doctor-patient relationship is the trust that holds between adults who respect one another, not between children and their parents.
The patient needs to know not only that the doctor is concerned for his welfare, but that the doctor will treat him as an adult whose life belongs to himself and not to the doctor.But in the end they do not outweigh the case for telling the truth. It might be useful to review the basic moral reasons favoring honesty, and then apply them to this case.First, patients have a right to decide whether to accept treatment or reject it.Along the same line, his wife has a right to choose whether to cut her tour short or not. Second, we make an implicit promise to tell the truth whenever we speak.(I owe this argument to Beauchamp and Childress, p. This is true for everyone, and still truer for physicians.This follows from their autonomy: their ability, and therefore their responsibility, to take charge of their own lives.Although chemotherapy and radiation are not likely to do Mr. He might want to try it, for the slim chance that it would prolong his life somewhat. B should be told the truth, as gently and supportively as possible. B has a right to the information, and the physicians own integrity demands that he give it.Obviously there are both psychological and moral reasons to find lying--or at least deception-- attractive in this case.He needs to know his condition so that the choice is his, not the doctors.As Munson puts it (using Kantian theory), the physician who conceals the truth "is not acknowledging the patient's status as an autonomous rational agent.