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Physicians' attitudes toward using deception to resolve difficult ethical problems
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1989
Year
Family MedicineBiomedical EthicDifficult Ethical ProblemsLawDeception DetectionHealth LawEthical PracticeMedical Decision MakingHealth CommunicationMedical LawEthical AnalysisBioethicsHealthcare EthicHealth Communication EthicsHealth PolicyInsurance PaymentHealthcare Professional BehaviorMedical EthicsMedical MalpracticeDifficult Ethical ChoicesMedicine
To evaluate physicians’ attitudes toward deception in medicine, a questionnaire was distributed to 407 practicing physicians. The survey presented difficult ethical scenarios potentially solvable by deception and collected general attitudes and practices. Among the 407 respondents, 52% answered; most indicated willingness to misrepresent a screening test as diagnostic for insurance, to mislead a spouse about a partner’s gonorrhea to secure treatment and preserve the marriage, and to withhold information from a family after a patient’s death, while few would deceive a mother about her daughter’s pregnancy, and physicians justified such deception by prioritizing patient welfare and confidentiality over truth. JAMA 1989;261:2980‑2985.
To assess physicians' attitudes toward the use of deception in medicine, we sent a questionnaire to 407 practicing physicians. The questionnaire asked for responses to difficult ethical problems potentially resolvable by deception and asked general questions about attitudes and practices. Two hundred eleven (52%) of the physicians responded. The majority indicated a willingness to misrepresent a screening test as a diagnostic test to secure an insurance payment and to allow the wife of a patient with gonorrhea to be misled about her husband's diagnosis if that were believed necessary to ensure her treatment and preserve a marriage. One third indicated they would offer incomplete or misleading information to a patient's family if a mistake led to a patient's death. Very few physicians would deceive a mother to avoid revealing an adolescent daughter's pregnancy. When forced to make difficult ethical choices, most physicians indicated some willingness to engage in forms of deception. They appear to justify their decisions in terms of the consequences and to place a higher value on their patients' welfare and keeping patients' confidences than truth telling for its own sake. (<i>JAMA</i>. 1989;261:2980-2985)