Lying v. Evasion - by David Thomas

I disagree with the author's assertion that there is no distinction between a physician lying to a patient and being evasive with a patient, especially when considering placebos. Lying to a patient in general is an outright deception of the patient since the patient has placed trust and given the physician paternalistic power. A physician being evasive obviously does not want to outright make the patient believe a falsehood, but at the same time may deem it necessary to leave facts out so the patient is not unnecessarily turned off from a treatment. The decision to be evasive or lie is an issue of paternalism, but its motives are driven by the morals of the physician. The physician is acting on his oath to do all he can for the benefit of the patient. Lying to the patient is equivalent to believing that the patient will be led to believe a different level of well-being than reality. An evasive physician wants to prevent giving a patient false hopes. For example, a physician may not give all the possible solutions to a problem because some of those possibilities would not work due to a patient's very complex situation. Here, the physician is only showing the patient the various effective methods and not including the possibly less effective alternatives.


This is still morally different than lying. A physician who lies about alternative possibilities for treatment does not allow the patient the possibility of knowing that alternatives are out there. Also, the physician assumes that the patient is completely unable to make an informed decision about the best course of action. It is well understood that two physicians may not look at the same problem and come to the same conclusion for a treatment. For this reason, "second opinions" are a way for a patient to determine if the course of action one physician decides as best can be considered as viable by other physicians in the same field.