Journal of Clinical Research & Bioethics

Navigating the Ethical Dilemma of Truth-Telling in Healthcare: An Analysis of a Case Scenario

Mehdi Hayat Khan^1*, Zubaida Akhtar², Rizwana Narjis³, Bushra Ashraf⁴ and Shazia Tufail^{5 1}College of Nursing, National Hospital and Medical Centre, Lahore, Pakistan
²College of Nursing, Shalmar Hospital, Lahore, Pakistan
³College of Nursing, D.H.Q Hospital, Jhang, Pakistan
⁴Punjab Institute of Cardiology, Lahore, Pakistan
⁵District Headquarter (D.H.Q) Hospital, Layyah, Pakistan
^*Correspondence: Mehdi Hayat Khan, College of Nursing, National Hospital and Medical Centre, Lahore, Pakistan, Email:

Received: 30-Mar-2023, Manuscript No. JCRB-23-20492 ; Editor assigned: 03-Apr-2023, Pre QC No. JCRB-23-20492 (PQ); Reviewed: 17-Apr-2023, QC No. JCRB-23-20492 ; Revised: 24-Apr-2023, Manuscript No. JCRB-23-20492 (R); Published: 02-May-2023, DOI: 10.35248/2155-9627.23.14.461

About the Study

A 45 year patient experienced a surgical complication following laparotomy and cholecystectomy. Three weeks after discharge, she presented with fever, abdominal pain, and tenderness. Her vital signs were as; B.P 107/73 mmHg, HR 92 beat/mint, Temp 101 F and RR 26 breath/minute. Imaging revealed a sponge in her abdomen, which was left during the recent surgery. Antibiotics were administered, and exploratory laparotomy was performed. The sponge was removed, and the affected area was cleaned with a septic solution. The incision was approximated. The patient was continued on antibiotics and discharged from the hospital.

Analysis of ethical dilemma

Truth-telling is a crucial component and healthcare providers have an ethical obligation to provide accurate information about their health. In these situations, where a patient has a lifethreatening condition, it can be challenging to disclose information about the prognosis [1]. The surgeon should inform the patient of his error, even if the end result remedied the harm. It is important for the patient to have a clear understanding of what happened during her previous surgery. Secondly, apologizing is not an admission of guilt, but rather recognition of the patient's feelings and experiences.

From the lens of organization

A Medical Graduate pledged that he/she shall abide by the principles laid down in the Code of Medical Ethics of the Pakistan Medical and Dental Council [2]. It is not uncommon for organizations, including hospitals and healthcare institutions, to make financial settlements to resolve potential liability issues. Ultimately, the goal of such settlements is to help ensure that patients receive fair compensation for any harm that they have suffered, while also helping to mitigate the legal and financial risks faced by healthcare organizations. Doctors perform practices with genuineness by following ethical principles, patient values, and beliefs [3].

From the lens of surgeon

Health Care Providers (HCPs) are always committed to do everything in the best interest of their patients, as it is mentioned in their oath “I will apply, for the benefit of the sick, all measures which will be required” [4]. Dishonesty in any form is considered unethical behavior in the medical profession. It could lead to legal and professional consequences for the physician, including loss of license and reputation. The Doctor should explain the family about the standards of practice but they also had to respect patient’s autonomy [5].

Counter arguments

Honesty, transparency, and informed consent are fundamental ethical principles in the medical profession, and surgeon is expected to uphold these principles in their interactions with patients [6]. Patients often seek medical advice and treatment during a time of vulnerability and uncertainty, and they rely on the expertise of physician’s recommendations, which can lead to better health outcomes and a stronger patient-provider relationship. In the Pakistan Health care settings, we especially value respect for personal autonomy and this necessarily demands truth-telling from the physician [7].

Analysis from both prospective

The omission of truth is a complex ethical dilemma that many of us face at some point in our lives [8]. In this case scenario, omitting the truth may seem like the right decision, particularly when it could protect someone's feelings or prevent harm [9]. Moreover, a surgeon decided not to disclose a patient’s sponge in her abdomen to their family members to prevent them from worrying or causing them undue distress. However, in such kind of cases, omitting the truth can lead to serious consequences, including mistrust, damaged relationships, and bad repute of healthcare organization. One approach to address the omission of truth was to consider the motives behind withholding information [10]. It's important to carefully consider all the factors and seek guidance or advice from ethics committees.

Conclusion

In conclusion, the omission of truth is a complex ethical dilemma that requires careful consideration and examination of our motives and values. While there may be valid reasons for withholding information, doing so can lead to serious consequences and violate ethical principles such as honesty, integrity, and respect for autonomy. It's essential to consider the potential consequences of disclosing or withholding information and seek guidance when needed.

Recommendation

Firstly, it is important for healthcare providers to follow established protocols and guidelines for reporting errors and adverse events to these committees. Secondly, healthcare institutions to have policies and procedures in place to address incidents of patient harm or injury and to ensure that patients receive appropriate acknowledgement, apologies, and compensation when needed. Finally, an ethical committee should be formulated who give solution in the light of ethical principles.

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