Truth Telling in Medicine: “Tell all the Truth but Tell It Slant”
I have posted many times in the past about truth. Truth is an important component of the fiduciary responsibility of the physician to his or her patient. But as with the physician’s prescription of a medication for treatment of a patient's illness, the maximum dose is not often the appropriate dose to prescribe, should the dose of truth administered to a patient be titrated too? But is a little truth not really truth at all?
With the words of Aristotle, “Poetry is finer and more philosophical than history; for poetry expresses the universal, and history only the particular”, I have looked to poetry for help in this ethical issue. I found the poem by Emily Dickinson titled “Tell All the Truth” which reads:
Tell all the Truth but tell it slant
Success in Circuit lies
Too bright for our infirm Delight
The Truth's superb surprise
As Lightening to the Children eased
With explanation kind
The Truth must dazzle gradually
Or every man be blind
I am not sure the poem has helped me in considering telling the truth in medical practice. Do doctors really know the real “truth” that they may pass on to their patients? Certainly there are unknowns. When the patient asks the physician “how long do I have to live?”, can the doctor know the truth to answer the patient? If the doctor doesn’t know the truth, should he or she simply say to the patient “I don’t know”? If you were a patient, would you want the doctor to tell you “the truth and the whole truth” or just a bit of the truth? If you were the doctor would you “slant” the truth as Emily Dickinson suggest? Any answers? ..Maurice.