LIE TO ME: THE ETHICS OF TRUTH-TELLING AND DECEPTION FOR ONCOLOGY

This dissertation deals with the ethics of truth telling and deception in medicine. Should clinicians tell the truth, even if the truth may cause patients irremediable psychological and physical harm? Are lies told with a benevolent intent always blameworthy? Are deception and concealment less culpable than lying? Should patients be informed that the medicine they are taking “with so many benefits” is just a placebo? How can physicians determine, between two alternative verbal disclosures, which one provides the optimal balance between truthfulness and beneficence? In this dissertation I endeavour to elaborate an answer to these and other questions by setting forth a normative theory of truth telling and benevolent deception for medical professionals, and especially for those operating in clinical oncology. Throughout this work I defend two main ideas. First, clinicians have a duty of veracity in all their professional communications, but in exceptional cases other considerations of beneficence and compassion may override this prima facie obligation. Second, clinicians may resort to clinical deception only if they have ruled out all other truthful courses of action and would be ready to hypothetically defend and actually disclose their behavior in public. This view, I contend, has several advantages over competing accounts and provides clinicians with a practical way of approaching moral dilemmas about truth telling and deception in clinical medicine.