Importance of Truth Telling, Confidentiality & Informed Consent in Medicine

Importance of Truth Telling, Confidentiality & Informed Consent in Medicine
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  • 0:01 Medical Ethics
  • 0:45 Truth Telling
  • 2:50 Confidentiaity
  • 4:33 Informed Consent
  • 5:55 Lesson Summary
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Lesson Transcript
Instructor: Christopher Muscato

Chris has a master's degree in history and teaches at the University of Northern Colorado.

The medical profession is full of important ethical issues. In this lesson, explore three major ethical concerns and discover how they relate to medicine. Then test your understanding with a brief quiz.

Medical Ethics

Today, I'm thinking about taking a tour of an institution where some of the greatest philosophical debates in the modern world are being held. Questions of ethics, morality, justice, fairness, rights, and responsibilities - all right here. That's right - we're heading to the hospital!

The world of medicine has been full of ethical issues for millennia, and some of the oldest moral codes in Western history deal with the rights and obligations of medical professionals. So if you're looking for a chance to discuss philosophy, there's really no better place to go for a nice, healthy debate.

Truth Telling

Tell the truth. That's a pretty basic moral rule that we're taught early on, but it's also a major ethical concern in medicine. Truth telling in medical ethics involves the moral duty to be honest with patients about conditions, medications, procedures, and risks, and this can often be unpleasant, but it is generally necessary. As recently as the 1960s, most physicians believed that patients would rather be lied to than told a horrible truth. However, this attitude fostered a large amount of distrust between physicians and patients, and trust is pretty important in this field. So modern medical ethics insist on honesty and openness.

Still, it's not as easy as it sounds. What if telling the patient the whole truth could interfere with the doctor's primary moral duty, which is to do no harm? Honesty is still preferred, but there are two situations where it is considered acceptable to not be completely truthful.

First, the physician may withhold some information if they truly believe that complete honesty will lead to greater harm, an ethical right called the therapeutic privilege. A fear of suicide in patients suffering from depression is an example of this.

The second situation is if the patient makes a conscious, informed statement that they don't want to know the entire truth. Maybe they want a family member to make medical decisions, for cultural or personal reasons. Maybe they are afraid that bad news will make them lose hope, while not knowing will encourage them to keep trying to get better. Both of the exceptions from truth telling are important to medicine but have to be treated very, very cautiously so that they are not abused.

Confidentiality

Amongst the ethical principles of medicine, another major one is confidentiality, or the obligation of a physician to keep a patient's health information private. This is pretty important, since patients have to trust their physicians but may be afraid to honestly admit to illegal or dangerous activity. Maybe they don't want the cops to know that they were doing drugs; maybe they just don't want their mom to know that they were being reckless. However, both of these things are really important for physicians to know before administering treatment. So as long as you're over 18, physicians cannot reveal anything that you tell them about your personal health without your written consent.

Again, there are a few exceptions. If the patient reveals information that could put others at risk, doctors may share it. For example, say someone with a mental disorder admits that they intend to commit a violent crime. Technically, that admission was confidential since it deals with their mental health, but it also clearly suggests a threat to other people, so the doctor may share that information with police. The other exception is with major communicable and sexually transmitted diseases. In the name of public health, physicians are required to report specific conditions, like AIDS, tuberculosis, or anthrax, so that public health officials can track and prevent the spread of disease. In this exception, the greater good is seen as more important than individual liberty and rights to privacy.

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