What is Truth-telling?

• Belief that someone is honest and will not cause harm. Truth-telling
informs the patients about their situations and enables them to make
informed choices about health care and other aspects of their lives.

• Fosters trust in medical profession and rests on the respect owed to

patients as persons. As mentioned earlier, truth is a belief that someone
is honest and will not cause harm, and it is with this conviction that
patients confide in doctors and seek advice.

• Puts emphasis on harm prevention as uninformed patients are informed

about their situation and whether medical help is necessary.
Moral issues of Truth-telling and
Confidentiality
(Physician-Patient Relationship)

The relationship questions the following:

• Is it justifiable for a doctor to deceive his/her patient?

• How much autonomy must be given up by the patient?

• What are the limits of paternalism that can be legitimately

exercised by the doctor?
Two approaches to the truth-telling
issue:
1. Person-Centered: emphasize the importance of the patient
as a person. This approach considers the patient as a person
with a problem, but not as a problem himself/herself.
2. Problem-Centered: stresses the nature of the problem or
the degree and severity of the patient’s illness. This
approach considers the patient’s problem, illness, or
condition and is usually appealed to by those who endorse
the legitimacy of placebos in medical therapy.
Justification for Truth-telling
– It is argued that our human and moral quality as persons is taken away
from us if we are denied whatever knowledge is available about our
condition as a patient.
– As patients, we have entrusted to the physician any knowledge he has
about ourselves, so the facts are ours and not his- hence to deny them
to us is to steal from us.
– The highest conception of the physician-patient relationship is a
personalistic one which is based on mutual confidence and respect for
each other’s rights.
– To deny a patient pertinent knowledge about himself, especially in a life-
and-death situation, is to deprive him the ample time to prepare for his
own death or to carry out responsibilities that are based solely on his
decisions or actions.
What is Confidentiality?
• Refers to medical or professional secrecy in which certain
information is committed to a physician in an official
capacity for the sake of medical assistance.
• The practical function of confidentiality underscores the
confidence, trust, and cooperation of the patient to the
physician.
• Is not absolute and under certain conditions, it is better
to violate it than preserve it.
Four conditions to justify the
Violation of the Confidentiality:
1. When keeping the secret would be detrimental to the
common good.
2. When the subject of the secret intends to inflict grave
injury upon an innocent third party.
3. When it is necessary for the subject of the secret to
avert grave injury.
4. When it is necessary for the one keeping the secret to
avoid grave injury.
Application of Ethical Theories
• Natural Law Ethics
– Maintains that each individual has an inherent worth and
so is entitled to know the truth about himself or herself.
– Considers the necessity of withholding information from
the patient on certain occasions for the patient’s well-
being.
– Relationship between physician and patient is one of trust
and confidence.
Ross’ Ethical Principles
– Physicians duty to the society is more stringent
than duty to the patient.

– Physician’s duty is to preserve the interest of

the society or to protect the common good.
Kantian Ethical Principles
– Truth-telling and confidentiality is absolute.
– Physician has an obligation to preserve the
confidentiality of the patient because keeping
promises is an absolute duty.
– Rules out lying for a patient is a person who is entitled
to receive information about his/her condition, no
matter how painful it may be.
Moral Principles of Situationism
– Consider the circumstances prevailing in a particular
situation

– One should make one’s decision in the name of

agapeic love or concern for the welfare of the patient
That’s All ^_^

Thank you for listening =D