Willful Ignorance: When Is It Acceptable?
Willful ignorance is the conscious intent of a person to avoid obtaining information about a matter. The issue is: What do you see is the significance of willful ignorance in medical practice? There are some interesting aspects of this question based on whether the willful ignorance is on the part of the patient or on the part of the physician. For example, do you ever think it is reasonable for a patient not to want to be told the results of a test or given a diagnosis or a prognosis about an illness or details about treatment? If so, under what circumstances?
Do you ever think it is reasonable for a person to refuse to be tested for a genetic abnormality.. if the person is healthy? ..if the person already has a disease that can have an associated genetic abnormality such as breast and ovarian cancer but the results of the test might be of significance to the health of family members? Or what about a family member who does not wish to know the results of a genetic test on another member? If the results of any test could have medical significance to the health of some other individuals, should the test be performed even if the person to be tested refuses to be told the results or even be tested?
Do you see any reason why a physician’s willful desire for ignorance regarding some aspect of his/her patient’s history or physical exam or test would have ethical merit or be professionally acceptable? For example, if a physician knew that the results of a test that the patient requested would most likely provide a result that would be ambiguous and if abnormal would only lead to additional procedures which, in the long run, would not be beneficial for the patient, that physician would desire ignorance (remember, it is the physican’s duty to interpret the test) and refuse to perform the test. (An example might be performing a PSA test to screen for prostate cancer in an 85 year old man.) Would that be ethical?
Well, what do you think? ..Maurice.