lect 6, 7 truth telling, confidentiality.docx

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University of Toronto St. George

Truth Telling  Patients have a right to refuse treatment  Autonomy of the agent being able to choose on accurate information  Interference with autonomy if being given only partial information or inaccurate information Against truth telling  Diagnosis might lead to depression, suicide, harm  reduction on quality of life  Patient might not want to know  Patient may not be able to understand medical terms  Might lead patient to choose wrongly For Truth Telling  Value of autonomy  Not telling will interfere with patient’s ability to choose treatments, life decisions, etc  Informed patients are better patients (ex: cooperating with painful/extensive treatments)  Patient have rights  If deception was revealed, will poison physician-patient relationship Cullen and Klein  Deception to benefit patient is wrong because it fails to treat the patient with respect  We are special because we can choose  the fact that I can’t tell you something whole truth doesn't mean can’t tell wholly truth, tell them everything they need to know to make a rational decision but don’t need to tell everything  telling truth to patient might harm and deceiving patient might benefit, then it’s acceptable Lipkin  truth is subjective  because the stress of being sick can distort patient’s thinking and because they lack understanding of medical concepts, it is usually impossible to convey to patients the full medical truth  patients hear selectively and with emphases not intended by the doctor  placebo effect implies that deception can be effective Thomasma  truth is not an intrinsic value but its valuable in that it serves other fundamental values (ex: makes autonomy worthwhile)  truth must be told as a right, utility and kindness  3 values the truth serves: truth is something we ought to stick to unless survival of the recipient is to be protected, or to give recipient time to absorb truth, or to protect survival of a community  Truth will eventually come out Confidentiality  Issue arises when patient’s will, autonomy, etc conflicts with other’s good Consequentialist arguments  in favor that holding patient’s confidentiality is important because honesty and trust is key to physician-patient relationship  physician starts with patient’s good rather than the good of others  always necessary to weigh benefits of confidentiality again cost, ex: more effective treatment, ways third parties will be affected by possible risks  never a possible absolute right to hold confidentiality  benefits of keeping confidentiality is not enough to outweigh the cost non consequentialist argument (autonomy-based)  to be an autonomous individual is to contr
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