Ethics is always a hot topic when discussing the medical profession. There are plenty of doctors who always make ethical decisions when dealing with their patients. However, there are times when ethics come into question because of information being withheld. Is it ever okay for a doctor to withhold information from a patient?
When looking strictly at withholding information from a patient, the American Medical Association (AMA) says that it should never happen:
Truthful and open communication between physician and patient is essential for trust in the relationship and for respect for autonomy. Withholding pertinent medical information from patients in the belief that disclosure is medically contraindicated creates a conflict between the physician’s obligations to promote patient welfare and to respect patient autonomy.
The AMA labels the withholding of pertinent information from a patient in a situation other than an emergency as ethically unacceptable. Doing so could leave medical professionals liable for claims of medical malpractice.
Recommendations from the AMA
The AMA makes the following recommendations when a doctor needs to either disclose or withhold information to or from a patient:
- Encourage the patient to name their preferred method of communication before any information has to be relayed to the patient
- Honor any request made by the patient to not relay specific information related to their health or relay the information to the proper surrogate or medical power of attorney
- Review the information that must be disclosed and determine how much of it at one time the patient will be able to handle
- Consult with other physicians, a committee, an ethics board, and even the family of the patient about the harm that could be caused by delaying the disclosure of information
- Monitor the patient closely and offer to provide complete disclosure once the patient is able to make a decision if they should receive full disclosure
- Disclose any medical errors that might have occurred while the patient was under the doctor’s care
Situations in which withholding information is not unethical
There are some situations in which withholding information from a patient is not considered unethical. For example, in an emergency where the patient is incapacitated and cannot decide for themselves whether or not they should have surgery. Another example would be a patient who has dementia or Alzheimer’s and would not understand the discussion. In this instance, it would be best for the doctor to disclose the information to a medical power of attorney, guardian, or any other family member permitted to speak on the patient’s behalf.
In these few instances, it would not be unethical to withhold information from a patient as they would find it difficult to process the information and make an informed decision because of their medical condition. This is often referred to as therapeutic privilege; whereas the doctor withholds information when he or she believes it might cause a psychological threat to the patient.