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Wednesday, May 1, 2013

The Lies We Tell in the Exam Room

By Abigail Zuger
The New York Times - Well Column
Published April 22, 2013

Here are some excerpts:

In a recent issue of The American Journal of Bioethics, a half-dozen ethicists chewed over the question of whether a decision to play Robin Hood with the medical insurer is actually ethical. Say that the patient’s health — or even life — is at stake: The insurer, for example, is refusing to pay for an essential test or medication unless the doctor writes down a bogus diagnosis the patient does not have. The experts came down firmly and eloquently on both sides of the issue.

Nicolas Tavaglione and Dr. Samia A. Hurst, both at the Institute for Biomedical Ethics at Geneva University Medical School in Switzerland, argued that lying for a patient under such circumstances was not only ethically permissible but mandatory. Helping a patient takes precedence over all other considerations, they wrote. Telling the truth would be “honoring an ideal principle in a nonideal world.”

Other ethicists protested, pointing out that too many doctors playing Robin Hood would make insurers tighten purse strings further. Dr. Thomas S. Huddle, of the medical school at the University of Alabama, Birmingham, wrote that all lies, even those told for a good cause, imperil the moral fabric of medicine. Dr. Robert M. Sade, of the Medical University of South Carolina, feared instead for the moral fabric of the doctor, pointing out that every lie “reinforces the habit of lying,” which then becomes easier and easier until the “morally disengaged” doctor is capable of really bad behavior.

The entire article is here.