Is It OK for Doctors to Lie?
If, after reading the title of this thread by those visitors to my blog who are NOT doctors, may well respond with "that is the dumbest question I ever heard! Of course, it's NOT OK for doctors to lie!". Well, perhaps it would be educational for that visitor to take a little quiz and see the issue of lying with the eyes of a doctor who has a trusting and therapeutic relationship with a patient.
This quiz (which was modified slightly by myself) was written by Martin Donohoe, MD, FACP who is adjunct lecturer in the Department of Community Health at Portland State University and a hospitalist at Kaiser Permanente Sunnyside Hospital. He serves on the Board of Advisors of Oregon Physicians for Social Responsibility (PSR) and is Chief Scientific Advisor to Oregon PSR’s Campaign for Safe Foods. His website is "Public Health and Social Justice" bears the text of the original quiz and many more tools for public and professional education about the medical issues covered by the website title. Please go there by clicking on the link. You will find the site expansive in terms of issues covered (from food and safety to women's health and women's rights). It is a valuable resource.
BUT FIRST, before you go. TAKE THIS QUIZ. But pretend you are a DOCTOR. Consider the nuances regarding lying which a doctor might have to face. And then write your answers as comments to this thread. This quiz is not as simple as it might at first appear. ..Maurice.
THE ART OF MEDICINE:
TRUTH-TELLING IN MEDICINE
AS A PHYSICIAN:
I. Would you “lie” in the following situations?:
1. A 26 year old male presents to the ER after suffering a radial fracture in an auto accident in which he was driving. He appears intoxicated, and a blood alcohol level is 0.17. When he sobers up, he asks you not to report him to the DMV, as he is afraid of losing his license. Do you report him?
- only if he hit another vehicle, rather than, say a lightpost?
- only if someone else was injured in the accident?
- if he’s a bus driver, would that influence your decision?
- if he’s a pizza delivery guy, and needs the job to support his sick infant?
2. A 33 year old female is admitted to the ICU with severe pneumonia. Evaluation is consistent with PCP pneumonia, and an HIV test is positive. She dies after 3 days. Her parents request that you leave the diagnoses of AIDS and PCP off of the death certificate. Do you accede to their request?
- if she is a celebrity or public figure, and the media may find out and inform the public?
- if the parents are fundamentalist Christians, and were the obituary to read AIDS, they tell you that they might be ostracized from their church?
3. A 45 year old licensed Nurse Practitioner at University Hospital comes to your office with symptoms of major depression. She requests that you do not include any information on her mental illness on the chart. She is afraid that one of her colleagues may access the computerized medical record and discover she is taking antidepressants, and that this could lead to her being ostracized or even losing her job. How would you handle this situation?
II. Would you lie in any of the following situations?
- diagnosis of cancer (at patient’s family’s request)
- STD (sexually transmitted disease) (at patient’s request)?
-“fudging” date of disease onset to avoid patient’s being classified as having a pre-existing condition?
- assuring an anxious patient that the surgeon he’s chosen is well-qualified, if you know her to be shaky? unsafe? alcoholic?
-Record the degree service provided as less than what occurred for the visits for self-pay patients?
- Record the degree service provided as greater than what occurred for the visits for well-insured patients?
III.. Finally, Is it OK for doctors to lie?
- sometimes? (If so, when? who decides?)