why does truthfulness matter? (4 reasons)
- legal reasons
- respect for persons
- shift towards patient centred care
- trust
respect for persons represents which theories
Kant’s deontology and relational ethics
truthfulness and autonomy go hand-in-hand because?
you can’t have autonomy without truthfulness – how can patients make decisions on their care without truth and knowledge on their care?
what is therapeutic privilege?
professional entitlement/privilege;
The old physician centred model - not telling patients the truth [about their condition] was normal/standard practice
doctors who defended therapeutic privilege used which virtue and how
Doctors who defended this used beneficence as an excuse to why they didn’t tell patients about their illness because they thought it would be more harmful to stress the patient [and assumed they would “take their life”]
why is trust important in healthcare (3 reasons)
- therapeutic relationships are based on trust, without trust it is hard for the RPN to build bonds with patients and patients should feel like they can be truthful with you, and you will be truthful with them
- Need broad public trust in the healthcare system – if people think the healthcare system can’t be trusted they won’t use it, and will only access health care services when its necessary
- to Follow public healthcare guidelines (trust in HC is essential for the public to do this)
Truth is not just about giving accurate information or giving facts, it’s about:
acting with the right intention out of a moral duty to be honest
acting with the right intention out of a moral duty to be honest is an example of which ethical theory
Kant’s deontology
which ethical theoretical approach should be step one when going in to see patients
Kant’s deontologists approach to truthfulness
in what 4 scenarios is it acceptable for the RPN to withhold the truth
- the patient doesn’t want to know the truth
- the institution has a no new information policy
- it is necessary to protect patient confidentiality
- to protect the anonymity of a clinical trial
withholding the truth from a patient because they don’t want to know is an example of what
respecting the patient’s autonomy
what is a a no new information policy?
any new information – test results, treatment plans, diagnosis – [anything] the patient doesn’t know must come from the physician; the nurse cannot give them the new information
what is the only time its acceptable to not tell the patient what medication they have been given
double blind experiment - to protect the anonymity of a clinical trial
it is not justified or acceptable to withhold the truth when: (3)
- a patient’s condition is serious
- when a patient’s condition is incurable (this demeans the patient - Considerations to be made are being withheld e.g., ability to work, travel, make wills, etc.)
- When the patient is cognitively impaired (patients who are cognitively impaired permanently, need to be told – but using a simple/easy to understand approach )
what are examples of grey areas in telling/withholding the truth
- disclosing the sex of an unborn child? (to avoid sex selective abortions)
- “lying” to patients with dementia? (e.g., patient believes they are younger than they are, are still married to someone, have young children etc.) – distraction is a better method
- What to do about patient delusions? – should we acknowledge the delusion as truth or tell them the truth and deny their delusions
