A survey in 2009 of 1,891 practicing US physicians found that 55.2% of doctors described a patient’s prognosis in a more positive manner than warranted and 19.9% of them did not fully disclose a mistake to a patient because they were afraid of being sued. Although the survey was done in the US, the issue of patients not receiving accurate information may also arise in Singapore and Malaysia.

How patients may not receive the right information


A separate study conducted in 2000 on dementia patients revealed that 30% of the subjects preferred not to be informed about their illness for a variety of reasons. Patients can choose to waiver their right to know about their medical condition, and it is up to the doctors to discern how honest they should be with the patient if that is the case.

Another possible reason could be for self-protection. From the author’s point of view, patients may not get accurate information on their medical condition in order to cover a mistake that was made by the doctor or his team members.

From a survey that was published in 2007 among US medical practices, it was revealed that only 41% of participants disclosed an actual minor error and only 5% disclosed an actual major error. The survey concluded that there was a gap between physician attitude and actual practice.

Apart from that, there are also cases where the doctor does not fully convey the truth because he does not want to worry the patient and his family, or aggravate the situation. Hence, he may choose to sugar coat the prognosis or the risk involved to the patient.

The doctor may also feel uncomfortable with delivering bad news, which results in him oversimplifying the explanation unknowingly, which consequently may lead to misinterpretation by the patient.

Additionally, therapeutic privilege could result in patients receiving wrong information; the idea of therapeutic privilege is based on the notion that when the doctor reveals certain information, the patient becomes upset or emotionally unstable and cannot make the right decision.

For example, a patient may not want to go through a particular procedure due to the risk that he or she may suffer from side effects or complications, even though from a physicians’ point of view, the benefits of doing so would far outweigh the risk.

Informed consent


A patient should be able to decide or make an informed decision based on the facts that he or she is given by the physician; not being truthful with the patient contradicts the idea of informed consent and ultimately violates the doctor-patient relationship.

In a study that was conducted in 2001, 99% of patients that were involved wanted to know the truth about their condition; 99% of them also felt that the doctor had an obligation to inform them about their condition, and 97% of them wanted to be told the truth if they had a life-threatening illness.

Essentially, the doctor should never undermine the patient’s autonomy and always make it a point to be honest as it is the foundation of the doctor-patient relationship, unless the patient himself waivers from his right to know about his condition. MIMS

Read more:
Helping patients participate in medical decision-making
Does sharing patient information improve healthcare?
Patients who leave ‘Against Medical Advice’: An ethical dilemma
How to smoothly end a patient encounter

Sources:
http://www.uchile.cl/portal/investigacion/centro-interdisciplinario-de-estudios-en-bioetica/publicaciones/76983/honesty-in-medicine-should-doctors-tell-the-truth
http://www.webmd.com/healthy-aging/news/20120208/doctors-honesty-put-to-the-test#1
http://content.healthaffairs.org/content/31/2/383.full.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2673833/
http://healthland.time.com/2012/02/09/white-coats-white-lies-how-honest-is-your-doctor/
https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/17473944/