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Summary
This article explores whether deception is ever justifiable in health care. It examines the concepts of truth-telling and deception. Possible reasons for the recent interest in truth-telling in health care are offered, including issues associated with deceiving patients. Wider arguments supporting and opposing deception in health care are considered before suggested alternatives to the use of deception in patient care are outlined.
Keywords
Codes of conduct; Ethics; Nursing: care
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THE NURSING and Midwifery Council (NMC) Code of Professional Conduct (2004) states that: 'All patients and clients have a right to receive information about their condition... Information should be accurate, truthful and... easily understood.' It also states that: 'As a registered nurse... you must be trustworthy.' The terms 'truth' and 'trust' are concepts that are often associated with the healthcare profession, particularly nurses who may be viewed by the public as model citizens (Higgs 1999). However, it is widely accepted that deception occurs in health care, as it does in every area of society. Some nurses may believe that deception is justifiable if it results in protecting patients from harm; many believe that telling patients the truth is the wrong course of action in certain circumstances.
Truth-telling and deception
If it is accepted that truth-telling is a necessary virtue for nurses, then truth-telling must be understood. Jackson (2000) suggests that truth-telling has two different meanings which are often confused. For Jackson, truth-telling means either 'to tell no lies' or 'to hide no truth'. These have different implications.
Lying means using falsification, purposely altering the facts, to intentionally mislead a person (Ekman 1985). An example of this would be to inform a terminally ill patient that he or she may recover.
Other methods of deception include 'deception without lies'. In other words, although no lies are told, the patient is not informed of the truth. An example of this would be the administration of covert medication (Blythe 2000). Although the administering nurse would not have lied, it is clear that he or she has deceived the...