Truth about lies...

[mshow00]

Honest opinions is it ever ok/good/proper to lie to a patient? In my EMT text book and my Paramedic text it says never... on the street I have seen both done. What is truly proper?

[akflightmedic]

Good question.

What is truly proper? I think that is more of a personal decision and heavily based on what is going on at that moment. No blanket policy fits this situation.

I choose my words carefully based on how critical it is and the patients knowledge, attitude, etc.

For example, if a child asked me if they were going to die, I would not say yes even if it were true. I would say you are very sick and I am going to take care of you. However if the parent asked, yes I would tell them.

An adult patients asks if they are going to die, I respond again, you are very serious and I will do my best for you.

If they ask if someone in the car has died, yes I usually tell them immediately so they will quit asking and redirect them so I can focus on them now. If they are showing signs of not being able to handle the info, I tell them I do not know as I am working on them but I will find out for them once we get to the hospital after taking care of them.

Prior to taking off for flights with critical patients, I have had spouses ask if their loved one was possibly going to die. I tell them it is a very real possibility and they should kiss and speak to their loved one now before I take off. (This was in the arctic where I had several hours flight time ahead of me).

As I said, it is all individual and you just have to use your gut and own judgment for that situation.

These are about the only situations where "lying" would be considered that I could think of at this moment. I do not think many or any other situations warrant lying. Now I have lied to parents(non patients) with juvenile patients when provided with information in confidence. They can find out at the hospital later, I just needed to know what I know to work on the kid at that moment.

[Dustdevil]

What is truly proper?

...and who decides?

This is one of those issues that simply cannot be addressed in any intelligent depth by a stand-alone EMT or medic school. There are too many variables. More variables than with medicine itself, which also defies black and white rules.

One thing I will say is, don't worry; this won't be on the National Registry exam.

It's a big theoretical debate, but in practice, it's actually extremely rare that you would be in a position that you would be tempted to lie to your patient. Those who are truly fixin' to die -- no doubts about it -- aren't talking to you anyhow. Most any patient who is still talking to you coherently actually has a pretty decent chance of survival, so what's to lie about? In a thirty-year career, you'll never cease to be amazed by the people who survive, when you swore they were down for the count. In this day and age, if you are that certain of somebody not surviving, then you probably shouldn't even be working them.

There are entire theses devoted to the discussion of whether half-truths are the same as lies, and the matter still isn't settled, so no paramedic class is going to settle it in a one-hour discussion. So, is telling your patient that his leg is pretty tore up, but not telling him that his leg is hanging by a thread a "lie"?

And what about "lying" to your patient about someone else's condition? This is the ethical dilemma that you will most commonly encounter. Two people in an MVA. One ejected, decapitated, and run over by three eighteen-wheelers. The other, with nothing but a concussion and sore back, is asking you how his wife is. What do you tell him? If your instructor is suggesting that you should tell this patient the truth, the whole truth, and nothing but the truth, then your instructor is a retard with no street experience.

Anybody suggesting that there are hard and fast rules to be adhered to in medical ethics is VERY short on experience, and has never taken an ethics course, both of which should disqualify them from teaching.

[Scaramedic]

#1 Medical Lie.

We're doing everything we can = you or your loved one is dead or going to die.

[JPINFV]

In general, I'd say that it is wrong to lie. The catch, though, is that lying is more than not telling the truth, and you don't always have to tell everyone the truth (redirect, refuse to answer, etc).

[AnthonyM83]

No, sir, I don't care that you're holding a gun, cops are not on their way.