by Lucius Trae

Created on: June 07, 2010

The question of whether a doctor should inform a patient about a terminal illness is fascinating. It's not the happiest topic, but it's came up within the context of philosophy. Although we all realize we deserve to be treated with respect, that doesn't always mean someone has to tell us the truth. Someone might end up in a situation where lying is done out of respect for our happiness. For instance, someone may be deathly afraid of spiders. If you find out the reason they were itchy at night was a bed full of spiders, you might want to say it was something else. There is no reason to traumatize them just to tell the truth.

However, there is a difference when it comes to medicine. More specifically, the family of the patient never wants to see a loved one get hurt, but they are too involved to make an impartial decision. The doctor knows the facts surrounding the case, and they may consult with the family about what options to take, but they should not be bound by the requests of a family to misinform the patient or withhold information.

It seems strange to consider lying to a terminal patient, but there are a variety of classic examples where it seems less inappropriate. One such example involves a doctor who is treating a patient they've had for years. This patient has finally saved up the money and taken the time to on a vacation with their family. It's likely to be one the best times of their life. Given this person's illness, they have some time left to live. However, the news is guaranteed to tarnish the experiences they have in the future - or perhaps cancel them altogether.

The health of the patient is the top priority of a doctor, but there is a reason the doctor cares about their patients health. They believe people deserve to be happy and spared from unnecessary pain. After all, most medical decisions are done on the basis of improving quality of life. A doctor will give the odds on a surgery, and they'll recommend it if it gives the patient a good chance at twenty more years of life. Alternatively, they'll recommend avoiding a risky surgery if someone is already at an old age and, as morbid as it is, likely going to die before the problem gets worse.

While it's ideal if a doctor can consult the patient, that won't occur in some situations, such as the vacation. If the family requests it, you'd have to wonder if they can keep it quiet. It's probably better the patient hear it from the doctor than their family, who likely doesn't fully understand all the details involved. But if the terminal patient is going somewhere away from, say, the only family who knows he is ill, it seems like it might be nice to not tell him.

Doctors make mistakes, and they aren't perfect judges. Unless some very specific criteria are developed, I don't think doctors or families should be keeping a terminal illness quiet. However, doctors are known to prescribe placebos in some cases, though many avoid the practice as it can undermine trust amongst the current and their other patients (if word spreads). For similar reasons, I think documentation should be a temporary solution. If people are filling out insurance or medical information for government records, they should be asked if they want to be opted-in to "organ donation," "placebo consent," and "terminal illness consent." I'm sure the doctors can make some more interesting titles for them, but I'd love to be able to consent to let a doctor spare me some bad news for a little while - especially if it would spoil a once in a lifetime opportunity.

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