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Response Paper #3: “On Telling Patient the Truth”
Bridget Propst
School of Nursing, Liberty University
PHIL 380: Biomedical Ethics
Dr. Foreman
December 7 , 2021
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Reasons to Justify Lying to Patients
Throughout Lipkin's paper about telling the patients the truth, he lists many reasons that
he justifies that lying to the patients is okay. Lipkin starts out saying words, especially when it
comes to medical terminology can be interpreted differently by each person. How we present the
words and go about with the conversation can lead to inaccurate information. Lipkin begins
using a cancer patient example, how unpredictable cancer can be and how it can be hard to
inform patients and have patients understand. It can be difficult to interpret the findings in certain
medical issues like cancer, so Lipkin comes to say that maybe holding the truth and giving a
vague answer is best. Upon his cancer examples, Lipkin then proceeds to talk about when a
doctor presents “heart trouble” to a patient. As he said “heart trouble” can refer to multiple or
completely different abnormalities that range on a scale from low to high in severity. Using
words like heart trouble or arthritis can mislead patients due to the many different possibilities
either of these has. It also depends on their knowledge base of what they know or has been told.
Lipkin discusses that most patients should be told “the truth” to an extent so they can
comprehend it. He does acknowledge that most people including physicians do feel
uncomfortable, but he believes good physicians are aware that some people can be badly
damaged by the truth. He proceeds to use placebos as his suggestion which brings a direct or
indirect presentation of the idea. Lipkin also mentions that good communication between the
physician and patient can be delicate and uncertain. That the language that most physicians use
can lead to misinterpretation. His final reasoning is that physicians like all of us hope to see good
results and get disappointed when something is going poorly. Upon that their reputation and
livelihood depend on how effective their work is, so for pure selfish ways they will say they will
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do what is best for the patient. Overall, Lipkin believes it is very difficult to tell patients “The
whole truth.”
I believe that they absolutely can find another way to inform without misleading,
misguiding, or having any misinterpretations when communicating with patients. In the medical
field, we are taught medical terminology and have a vocabulary that people who are not in the
medical field necessarily do not understand, but we know to break down those such words to
where anyone can understand. Now making sure they understand the concepts of what may be
going on all deals with patient teaching. You should not let a patient go or discharge a patient if
they do not have any knowledge or understanding of what has been diagnosed and what is going
on with them. We are taught and tested on how to exactly patient teach patients and family
members of patients, so we should be doing it every day. Overall, I believe it is
miscommunication entirely between patients and healthcare providers. Though the result of
something may be horrifying overall, we are taught to deliver “bad news” when it comes to
diagnosis, so we should not be holding back information from them. They have the absolute right
to know what is happening and what all approaches can be taken to help the situation or to cure
it. I believe that having to deliver bad news is no excuse for lying, lying to the patient can be
considered as malpractice and can lead to the removal of license if it escalates further. The
alternative for not lying is, to tell the truth, explain, be patient, teach, inform, and deliver with
professionalism and care.
Ethical Classification of Lipkin
I would classify Lipkin as a utilitarian. Utilitarianism is a moral theory that improves life
by adding pleasure and happiness while also reducing the negative and bad things. Lipkin
thought process is that as long is that they are doing right in their mind and leaving out the
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negative. Lipkin believes what he does with lying is justifiable if the patients are not miserable.
That if they are happy, they do not need all the information. Throughout the article, he has a tone
of utilitarianism even when going into the topic of medical terminology and understanding it.
Saying that it is ok if the patient can understand what is going on or the severity if they are
content.
The Attitude
Unfortunately, this seems to be the attitude that most medical providers have today. In
this field, many things can become very complicated and can be difficult and harsh. But that is
no excuse for lying to patients about what is going on with their health. We are taught, trained
and experienced how we should handle this situation. Patient teaching is a big part of nursing
and health care providers. If we are lying and not telling the whole truth, we are simply not doing
our job. We can find other ways to have patients cooperate and do what we need to do without
lying. Overall, they do have the right to reject treatment so therefore if they end up rejecting it,
that is their choice. But our job is to teach them what is going on, what needs to be done, and
what does this looks like timewise.
