When Telling the Truth to Patients Is a Hard Thing to Do

In class this week the topic on truth-telling and deception was visited. Some cases that we focused on are represented in categories such as dying patients and interventions. We all know that truth-telling in clinical cases are a very difficult topic. An example of an intervention clinical case that our textbook gave is below.

In this case a young Hispanic woman is in a coma and in the process of coming out of the coma. The only responses she makes are from commands. Since this woman is not in a situation in which she can make decisions for herself, her mother and father deal with all of her healthcare decisions.  Her boyfriend is also accepted in the family, so when it is later discovered by physicians that this woman is five weeks pregnant the physicians ponder on how to handle this condition.  Because if she does not recover from this coma the physicians will then have to inform the patient’s decision makers, who will then be in a position in deciding whether to continue the pregnancy even if it is a harm to the young woman’s recovery.  Therefore, the physician exposing this information will cause problems in the family. For example, why should the young woman mother get to decide what to do about the pregnancy? Shouldn’t the father/boyfriend decide since it is his child?

According to David Thomasma, author of this clinical case, “revelation of the truth must be carefully managed.” Furthermore, the pregnancy should be revealed only when it is critical to the patient health\survival. This clinical case is an example of how the truth is somewhat hidden from not the patient, but from the patient surrogate decision makers. This case to me is a bit arduous, because the patient autonomy is not at all violated because she incompetent to decide for herself. But does this make it morally right for the physician to withhold information from the family because the physician feels that it is not important for the family to know at the current time? In this case like all other clinical cases, I have the perspective that questions what gives the physician the right to decide what information he chooses to share with the family. Specifically in this case, the father should of course know that his girlfriend is pregnant with his child. Withholding this truth is not going to change the state that the woman is in. So therefore, I feel that the physician should not hide this information.