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Doctor’s Views On Disclosing Or Withholding Information On Low Risks Of Complication

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Abstract

Background

More and more quantitative information is becoming available about the risks of complications arising from medical treatment. In everyday practice, this raises the question whether each and every risk, however low, should be disclosed to patients. What could be good reasons for doing or not doing so? This will increasingly become a dilemma for practitioners.

Objective

To report doctors' views on whether to disclose or withhold information on low risks of complications.

Methods

In a qualitative study design, 37 respondents (gastroenterologists and gynaecologists or obstetricians) were included. Focus group interviews were held with 22 respondents and individual in‐depth interviews with 15.

Results

Doctors have doubts about disclosing or withholding information on complication risk, especially in a risk range of 1 in 200 to 1 in 10 000. Their considerations on whether to disclose or to withhold information depend on a...‐.

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Don’t Lie But Don’t Tell The Whole Truth: The Therapeutic Privilege – Is It Ever Justified?

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Summary

This position paper will show that withholding information from a competent patient is a violation of the doctor's role as a fiduciary and is not ever justified. As a fiduciary, the doctor's relationship with his or her patient must be one of candour since it will be impossible for the patient to trust the doctor without regular candid information regarding the patient's condition and its outcome. Although the use of the therapeutic privilege has been recognized by several courts and is supported by scientific literature, I will explore why withholding information from a competent patient is a violation of the doctor's role as a fiduciary and as such is not legally or ethically defensible.

While some courts have recognized the therapeutic privilege as a way of promoting patient wellbeing and respecting the Hippocratic dictum of “primum non nocere” {or first do no harm},

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Lies in the Doctor-Patient Relationship

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Have you ever lied to your patients or been surprised to learn that one of your patients lied to you? Have you considered it important to learn why lies emerge in the treatment relationship? Have you wondered whether (or how) you should confront such untruths? If you have, then the following discussion should provide the forum for answers to these and other questions related to the exploration, detection, and management of lies in the medical arena.

Clinicians realize that making an accurate diagnosis relies on the provision of reliable information by patients and their family members and that timely, astute, and compassionate care depends on effective bidirectional communications (between the patient and the physician). Unfortunately, both patients and physicians are often challenged by complicated communications; each group withholds, distorts, obfuscates, fabricates, or lies about information that is crucial to the doctor-patient relationship and to effective treatment....

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