Physicians' attitudes toward using deception to resolve difficult ethical problems

Article Abstract:

A group of 407 physicians was polled to determine their attitudes towards using deception to solve ethical problems in medical practice. Two hundred and eleven physicians responded to the poll, and most seemed willing to engage in some form of deception in the face if difficult ethical choices. Four scenarios depicting ethical questions were presented in the questionnaire. In two of the hypothetical cases, most physicians were willing to use some form of deception: misrepresenting a screening test as a diagnostic test so that the patient's insurance policy would cover the cost; and misleading the wife of a patient with gonorrhea to insure that she be treated while hiding the circumstances and nature of the husband's illness to preserve the marriage. In another hypothetical case, in which a physician's mistake led to a patient's death, only one third of the physicians polled indicated that they would not admit the mistake to the patient's family, but would rather report incomplete or misleading information. In the last case, very few physicians indicated that they would deceive the mother of a pregnant teenage girl regarding the girl's condition. The physicians' responses seemed to place a higher value on keeping the confidences of their patients and doing what they felt was in their patients' best interests than on telling the truth.

Medical ethics

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A model of empathic communication in the medical interview

Article Abstract:

Physicians can improve their relationship with their patients by learning to recognize an opportunity to empathize with the patient. Researchers analyzed videotapes and transcripts of 21 office visits. They identified many times during the visit when the patient made a direct or indirect emotional statement that was missed by the physician. Many patients tried repeatedly to solicit empathy from the physician while the physician tried to steer the conversation back to an exploration of symptoms. Lack of compassion has been a factor in some malpractice lawsuits.

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Calibrating the physician: personal awareness and effective patient care

Article Abstract:

Medical schools and residency programs should consider a series of workshops and discussion groups to help physicians understand their own communication patterns. This could improve their relationships with their patients. Physicians should examine their own beliefs and attitudes as well as family influences. They should explore how they react to difficult patients, dying patients and medical errors. They should understand how they react to and manage stress. Group discussions, support groups and Balint groups can assist in this process.

Study and teaching

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