How the doctor's nose has shortened over time; a historical overview of the truth-telling debate in the doctor-patient relationship

摘要

In medicine, the legitimacy of deception has been the subject of debate for centuries. Fletcher called the issue of truth-telling an ‘old and perennial problem, giving cause in every age to complaints against doctors as masters of equivocation.’1 Despite the categorical rejection of deception in several codes of ethics, the moral acceptability of deception is still a contentious issue in contemporary medicine.2-4 In many parts of the world, it is common for doctors to withhold a diagnosis of cancer from their patients.5-8 In this article, I shall not debate the ethics of truth-telling and deception, but will rather present some historical antecedents to the debate and provide reasons behind the transition, in the Western context, from a deception-friendly professional disposition to an overtly deception-phobic one. However, many of the ethical arguments for and against benignly intended deception are as germane today as they were at the time.