Although physicians may justify lying to patients because it is motivated by beliefs of what is best for their patients, physicians may often lie for their own sake — furthering the debate on what medical lies are ethically acceptable, two Chicago physicians argue in a STAT op-ed.
Here are six takeaways from the op-ed, written by two physicians at Ann & Robert H. Lurie Children's Hospital of Chicago — neonatologist Nana Matoba, MD, and pediatric cardiologist Angira Patel, MD.
1. The authors argue physicians, including themselves, "tell these untruths" to parents of pediatric patients in critical condition not to deceive them, but to improve their spirits in times of despair. "We do it, we tell ourselves, to spare their feelings," the authors wrote. "But perhaps we sometimes lie for our own sake, and it is our feelings that need to be spared so we can get through the night without breaking down in the call room…"
2. "In an imperfect healthcare system limited by resources, the morality of whether physicians should advance what they believe is in the best interest of their patients above and beyond existing rules and regulations can be debated," the authors wrote. However, white lies can be problematic, especially when considering arguments among medical ethicists that surround the moral distinction between lying and deception.
3. Physicians have wrestled with telling absolute truths versus withholding often bleak facts from patients, the authors wrote, noting a study that found more than 55 percent of physicians sometimes or often described a patient's prognosis in a more positive manner than the facts support.
4. "In reality, the flowchart, or saying 'I don't know,' doesn't always help," the authors wrote. "And being brutally honest doesn't always help families make decisions or guarantee the preferred outcome." Physicians should be sure to cite statistics of morbidities and mortality to families, such as, "Your child has a 60 percent chance of survival," the authors added. However, "giving hope and sometimes describing a prognosis in a more positive manner than the facts might support is the reality of what physicians do."
5. "To be sure, deception that limits an individual's or a parent's ability to make informed decisions is reprehensible," the authors wrote. "Patients and their family members must be told results and expectations based on experience and evidence, as honestly and as clearly as a clinician can. But the art of medicine calls upon us to be nuanced and possibly shield them from unnecessary pain."
6. Physician-patient relationships can remain strong even when physicians tell patients "white lies," the authors concluded, "as long as our actions are grounded in kindness and we are doing our best for our patients in difficult times."