Blackwell Reference Online

Extract

Telling the truth is one of life's basic rules. Why should this subject still be of concern in medicine? One answer was provided by a recent discussion in a postgraduate seminar. Looking back at some of the perplexities of her early medical training, a specialist now in middle life described her first day as a junior in a surgical team in the UK in the 1980s. Exhausted after a night of emergency admissions, she was flustered by the irascible style of her new boss on the next day's ward round, and was unclear about whether some important tests had been performed or not. The senior, in response, suggested she was covering up an inadequate performance, and warned her not to tell lies on his unit. A few minutes later, as the team round reached an elderly man with widespread metastases, she was instructed by the same senior not to tell the patient how near death he was. At the end of the round, brushing past some bedside lilies in his expensive suit, her boss left for his private office with a big yellow pollen stain on the sleeve of his jacket. She decided to stay silent.Bullying behavior is never acceptable, but that was not the point of her story. She was presenting the struggle to reconcile three common strands of thinking deeply embedded in the tradition of most societies. Lying is unacceptable behavior, but doctors seem to have been allowed from time long past to “treat truth like ... log in or subscribe to read full text