Doctors are Liars

Deception flowchart

Case study: the unhopeful anaesthetist
A patient with a ruptured aortic aneurysm is rushed to the operating theatre. The anaesthetist knows the patient's chances of survival are poor. Just as preoxygenation is about to begin, the distressed patient asks "I am going to be all right, aren't I, doctor?" Can the unhopeful anaesthetist justifiably deceive the patient?

Brief flowchart analysis
The strongest reasons for deception here are to prevent great psychological harm and compassionate (humane) deception. As the patient will be conscious for only a short time, the deception is likely to succeed. A truthful alternative needs quick thinking and careful phrasing and therefore runs a higher risk of distressing the patient. As non-lying forms of deception (such as the evasive "we'll do our very best") might arouse suspicion, and as the likelihood of eventual discovery is minimal, lying is preferable for reducing such harm.

The main objections to deception are violation of the duty to be truthful, respect for patient autonomy, and the "right to know." Given the anticipated intensity of the distress, however short lived; the lack of realistic alternative clinical options; the negative impact of delay on an already poor prognosis; and the improbability in the remaining seconds of the patient coming to terms with the grim truth, the balance might justifiably be judged to fall on the side of deception. In light of the reasoning above, I would be willing to justify my decision to colleagues and the General Medical Council and believe many reasonable people might want to be deceived in such circumstances. I conclude that the proposed deception is morally acceptable.

Article published in BMJ on 12 May, 2007


It's official. Doctors do lie! Is it ever ethical to lie to the patients? Do you want your doctor to lie to you? Is there a therapeutic benefit in lying to the patients? Will the truth kill off the patients earlier?

You would be very angry if your banker lies to you, right? Or for that matter anyone else. So, why is it ok ( or not?) if its your doctors, especially if your life is in their hands? The Casual Philosopher is in a dilemma....