Should patients always be told the truth?

Truth-Telling in Clinical Practice and the Arguments for and Against: a review of the literature

“…99,100 Telling rather than withholding information allows the patient to plan care, seek another opinion and put personal and financial affairs into order. 25,57,101,102 Furthermore, truth-telling maintains the competent patient's status as an adult 103 and promotes a health care context (and society) as one of equality and freedom. 104 Numerous studies of a variety of groups show that patients generally desire truthful disclosure, including the bad news of failed treatment or death.…”

Examining patients' preferences for participation in clinical decision‐making: the experience in a Latin American chronic obstructive pulmonary disease and cancer outpatient population

“…Current opinions and practices regarding the importance of truth‐telling, however, are mostly derived from studies of Anglo‐Saxon or migrant patient populations in the United States and may not always take into consideration that truth‐telling practices and preferences are a cultural artefact that cannot necessarily be extrapolated to diverse cultural contexts. Truth‐telling, however, has been shown to contribute to patient distress, anguish, depression, hopelessness, pain and anger, and does not necessarily result in improved quality of life . Furthermore, patients with irreversible or ultimately fatal disease such as cancer or advanced COPD are particularly vulnerable to physician behaviours .…”

The care encounter: Pondering caring, honest communication and control

“…64,65 Therefore, discussion of 'bad news' is avoided as it contravenes perceived duties of benevolence and non-maleficence. 66 These two action-guiding principles direct another to be deceptive on the grounds that truth disclosure to a patient might cause distress, 67,68 anguish and depression, 69,70 pain, 71 anger, 72 and might diminish hope. 42,[73][74][75] Others propose that deception can or has been used to preserve and protect lives and save another's feelings.…”

“…75,79 Therefore, 'patients do not want to hear bad news'. 67,71 Alternatively, the patient-doctor relationship, perceived as 'legalistic, commercial, and contractual rather than something divine or artistic' demands a different sort of truth. 80 The relationship, recognized as contractual, authorizes the doctor to minimize harm to the patient and to the family by whatever means the doctor deems neces-sary.…”

“…That is, because of these consequences, deception is chosen to avoid harm and promote well‐being 75,79 . Therefore, ‘patients do not want to hear bad news’ 67,71 …”