This is your first time to care for Ms. X. You hear in report that Ms. X’s family does not want her to know she has a terminal condition. This should raise in your mind a number of questions: Why does the family know the diagnosis before the patient? Is Ms. X capable of understanding what her diagnosis means? Can she make decisions for herself? Honoring the family’s request for secrecy means that you, the nurse, may not speak honestly with Ms. X, even if she asks you a direct question.
When we look to ethics for answers we are trying to determine the right action to take. Values tell us why we do what we do. At Clarian, respect is a core value. We show respect by telling the truth. Honesty is the foundation for a trusting relationship with patients and their families. Respecting patients means we support their right to participate in all decisions about their care, unless there are legitimate, compelling reasons to hide the truth.
The nurse caring for Ms. X must uncover the nature of the family’s request: Is the request based on a cultural tradition? Has Ms. X told her doctor she wants her family to make decisions for her? If the information in report is accurate and the physicians and others taking care of Ms. X endorse withholding information from her, there must be documented evidence of the plan and the process followed to arrive at it.
There are circumstances when not offering the truth to a patient is how we respect them, but the evidence for the ethics of this action must be clear to all who care for Ms X. The Clarian core value of respect suggests we could not ask our employees to be dishonest with a patient if asked a direct question, no matter what a family member believes is best for the patient.
It is one thing not to disclose information, based on knowing a patient. It is quite another to lie.
Lucia Wocial, PhD, RN
Clarian Health Nurse Ethicist
To join the Registered Nurses at Clarian, visit Registered Nursing Position Indiana
When we look to ethics for answers we are trying to determine the right action to take. Values tell us why we do what we do. At Clarian, respect is a core value. We show respect by telling the truth. Honesty is the foundation for a trusting relationship with patients and their families. Respecting patients means we support their right to participate in all decisions about their care, unless there are legitimate, compelling reasons to hide the truth.
The nurse caring for Ms. X must uncover the nature of the family’s request: Is the request based on a cultural tradition? Has Ms. X told her doctor she wants her family to make decisions for her? If the information in report is accurate and the physicians and others taking care of Ms. X endorse withholding information from her, there must be documented evidence of the plan and the process followed to arrive at it.
There are circumstances when not offering the truth to a patient is how we respect them, but the evidence for the ethics of this action must be clear to all who care for Ms X. The Clarian core value of respect suggests we could not ask our employees to be dishonest with a patient if asked a direct question, no matter what a family member believes is best for the patient.
It is one thing not to disclose information, based on knowing a patient. It is quite another to lie.
Lucia Wocial, PhD, RN
Clarian Health Nurse Ethicist
To join the Registered Nurses at Clarian, visit Registered Nursing Position Indiana
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