to lie or not to lie ; to tell or not to tell

by this time of my life, i keep seeing myself in the medical education field. to be exact, in a public health department. i keep thinking how great it would be like to educate future doctors to be good doctors, or to some extend, a better human being.

today's discussion in ethics course was about breaching confidentiality. and then we moved into a new subject, "Telling the Truth". interesting. my professor goes like, "in a study conducted, it is found that a vast majority of the doctors tell the patient, less than the whole truth". 

"if you have a patient, who has incurable cancer and has few months to live, would you tell the truth?". i nodded. hell, if i have few more months to live,i'd prefer knowing the fact than not. at least i know i should cherish every single second available. and the reasons are presented such as, "why destroy hope", and holding fast to the 'do-no-harm' oath. on the other hand, in another study conducted, patients would prefer to be told about their exact condition. and of course the lecture continues with the professor discussing stuff like, ignoring  your patient's question is considered as doing harm to your patient too. yada yada yada.

one point that i love from today's lecture is that "not telling the truth, the whole truth equals to telling lies". true isn't it? there are things that we kept to ourselves, not wanting others to find out about it. we all have our own skeleton in our closets. speaking of patient-provider relationship, which was supposed to be built upon trust, not telling the whole truth, or in another word we say "lying" to your patient, is definitely going to ruin this. like, your patient would go, "if u can lie to me about this, God knows what else have u been keeping from me". and perhaps it'll be a major dilemma for that particular person to distinct, which of the things u said are truth or lies. 

and lying about things, pictures our real moral value. not only as a physician, but also as a human being. my professor's example was, "if someone calls you in the middle of the night, and ask are you sleeping, why do you have to say "NO". just say "Yes, i was sleeping"". and i was like, "OMG, that's totally me!". and perhaps you do the same thing to. we just dont want the other party to feel guilty about disturbing us, or perhaps we just dont want to give any bad impression on them. 

keeping the whole truth from a patient, is totally contradicting to the patient's autonomy principle. where we should provide all the information we have and let the patient choose for him/herself. which takes us to the next point, we keep this information because we want to be in control of the situation. violating another principle we should hold on to, being collectively oriented, putting the patient's interest first. see?

Trust-Based Relationship

we moved to real-life practice, cuz basically we're not seeing patients just yet. relationship is always based on trust, not love. trusting the person you love drags you into severe denial when thing goes wrong, you start to blame everything else but that particular person, simply because love DO make people blind.. but loving the person you trust, perhaps is not as difficult. (totally theoretical, i can't prove this anyway).  

we lie. for god-knows-whatsoever-reason we have. or justified. and often we say, i lie or in a nicer way "i didn't tell you" because i don't want to hurt you. or in the patient-provider relationship, because i don't want to make you feel bad. LOL. that's a real bull! you never lie for other people. you lie for yourself. you either can't take the 'guilt' or you just don't want to have to be responsible if things get out of control after telling the truth. every time you say you don't to hurt another human being, you're just saving your own ass. 

the terminally ill. 

i'd prefer my patient, and his/her family be prepared for the worst. it's not about the news you're delivering, it's how, or the way you present the news. you can tell a patient he has two months top to live, and still he could be thanking you for that. if i were to choose, letting a patient die abruptly, without knowing that those days were his last few to be with his beloved ones, or to tell him that he's running out of time, and he should be cherishing every second left and be inspire him to lead a great ending, i'd go for the latter. 

it's God who determine who stays and who has got to go. not me or my prognosis. and just to reassure you that telling the truth is the only ethical thing you could do,

"قولوا الحقّ و لو كان مرا".

have a nice day everyone. don't lie.