I would like to dwell on the controversial issue of telling or withholding information from patients. Honest and frank communication between the nurse and the patient is crucial to the efficient delivery of treatment. Also, nurses demonstrate their respect and trust to patients by telling the truth about symptoms, diagnosis, and treatment options. However, there are situations when the disclosure of truth may be too shocking or may have a negative impact on a patient’s health. The task of the nurse is to identify whether the truth should be told. Lying or hiding information may result in unpredictable consequences. I would like to introduce my thoughts about the issue under consideration.
The primary concern is the importance of honesty for patients. Numerous surveys have been conducted to identify the relation of people, to tell the truth in the healthcare environment. According to one of them, 90% of respondents would like to know the truth about their medical condition, even if this is a terminal disease (Truth-telling and Withholding Information, n.d.).
I believe that telling the truth is crucial as far as the patient should make decisions about proper treatment and further actions. The nurse should provide all necessary information about a diagnosis, potential treatment options, prognosis, and consequences of treatment. However, it is not required to burden the patient with unnecessary details concerning the medical condition.
The ethical dilemma occurs when it is estimated that the truth may be harmful or too shocking for the individual. Such worry is especially relevant when it comes to informing about terminal diseases. A more controversial situation occurs when the family of a terminally ill patient asks to hide the truth. There is no doubt that the family’s motives are purely positive, but the nurse faces an ethical dilemma. As Punjiani (2013) states, “The definite issue is whether a nurse by respecting the family’s wish should keep the truth from her terminally ill patient, or by abiding the Code of Ethics for Nurses, should disclose the truth to the patient” (p. 1). The Code of Ethics for Nurses presupposes that nurse should provide care for patients and their families. However, the nurse aims to satisfy the patient’s needs first for. I consider that the proper variant is, to tell the truth to the patient despite the family’s request. Also, the nurse should try to explain the significance of telling the truth to the family members.
Apart from the Code of Ethics for Nurses, the principle of autonomy should be used for justification for telling the truth. The principle of patient autonomy presupposes that no decisions should be made without patient’s consent or wish. This principle allows patients to determine their treatment and further life. I share the opinion that patients should be told the truth so that they can choose a treatment plan. The ethical principle of beneficence may be applied to such cases too. Thus, according to this principle, nurses should do everything possible to promote a well-being of the patient. Telling the truth about serious illness, for instance, may become an impetus for the patient to do something important in life. However, one may argue that it is only one side of the coin. The truth may become a burden to the patient or may lead to the aggravation of the situation. One more principle should be mentioned as well. It is the principle of veracity that supports the idea of telling all relevant information to the patient. The nurse happens to be in a controversial situation as far as the reveal of truth may be considered as a disregard of family’s wishes. The most appropriate solution in such case is to analyze the clinical context.
The nurse has to evaluate the physical and psychological condition of the patient. The withholding of truth may be possible only in two cases. The first instance refers to the existence of evidence that proves that information may be harmful to the patient. For example, the truth may not be told to patients who are inclined to commit suicide. The same is the situation with other patients who are mentally unstable. The second possible option for not telling the truth is the patient’s refusal to participate in the decision-making process related to his or her treatment. Also, the patient may consent not to be provided with information about the diagnosis. Patients with particular religious beliefs may also prefer not knowing the truth about their medical condition.
To conclude, I would like to emphasize that I support the idea that the truth should be withheld only in two described cases. As Drane (n.d.) writes, “Now truth, in the sense of reporting known factual information, is considered a public health responsibility and more important than a patient’s right to control or to individual autonomy” (para. 10). Although this statement is straightforward, it describes the tendency and the growing significance of knowing the truth.
Caddell, A. (2013). Accepting Gifts from Patients. Canadian Family Physician, 59(12), 1259-1260.
Chinn, P., & Kramer, M. (2014). Knowledge Development in Nursing. Maryland Heights, MO: Mosby.
Drane, J. (n.d.). Honesty in Medicine: Should Doctors Tell the Truth?
Punjiani, N. (2013). Truth Telling to Terminally Ill Patients. Clinical Research & Bioethics, 4(4), 1-2.
Truth-telling and Withholding Information. (n.d.). Web.
Weijer, C. (2001). Gifts Debase the True Value of Care. Western Journal of Medicine, 175(2), 77.