Lying in emergencies

[DavidOdden]

As for a violation of rights, I think about it from the judge's perspective if such a case went to court. If the patient really wanted to die, then maybe he could sue the doctor for the cost of doctor-assisted suicide, plus additional damages for pain and suffering. If the patient really wanted to live, and the doctor gave him a life-saving treatment against his wishes, and then the patient sued the doctor, then I would never allow the case to even get to court.

There are two cases that you don't cover, the important ones. One is if you lie to the patient to secure permission to undertake the treatment, perform the procedure, and the patient does not get better (arguably as a result of the treatment). Then you would rightly be in deep doo-doo. Second, you could lie about the nature of the treatment and save a patient's life which might, for example, involve a blood transfusion (and the patient is a Jehovah's Witless). While I think their transfusion-avoidance belief is lunacy, it's their right to be lunatic, and thus it is a wrongful assault to treat a patient in a way that they do not / would not consent to, and covering up the fact that an aspect of the procedure involves something that is moral anathema to the patient is a wrongful act. In that case, the doctor should tell the truth to the patient, should not obscure the central point if there is confusion ("Yes, this does involve transplanting an organ"), and should act in accordance with the permission granted by the patient. To do otherwise is, plain and simple, assault. Even if it's surgery on an idiot.

The point here is that lying is not generally good but it can be okay in certain cases, to calm a patient who might otherwise die from shock. But in pursuit of the goal of saving the patient's life, you cannot negate the higher requirement of informed consent.

[dan_edge]

David,

One is if you lie to the patient to secure permission to undertake the treatment, perform the procedure, and the patient does not get better (arguably as a result of the treatment). Then you would rightly be in deep doo-doo.

I agree fully.

Second, you could lie about the nature of the treatment and save a patient's life which might, for example, involve a blood transfusion (and the patient is a Jehovah's Witless). While I think their transfusion-avoidance belief is lunacy, it's their right to be lunatic, and thus it is a wrongful assault to treat a patient in a way that they do not / would not consent to, and covering up the fact that an aspect of the procedure involves something that is moral anathema to the patient is a wrongful act.

That's an interesting case. I don't know if the Jehovah's Witness could win a civil suit against the doctor, but you suggest the state should punish the doctor for assault. This would also most likely violate hospital policy, and the doctor could be fired. That said, if I am the judge in his criminal case, and the doctor is a 1st time offender, I still probably throw the case out of court.

I wonder what hospital policy would be if it weren't for all the regulations placed on them today? Could a hospital require that, if you come in for emergency care, then you must allow the doctors to perform certain procedures (like blood transfusion)? Since it may be hard to prove that the patient refused certain forms of treatment, it may be in the hospital's best interest to require that one consent to certain procedures before admitting him for emergency treatment. They don't want to get sued by the patients family if he dies.

I'm getting off the subject though. The original question was one of ethics, not legality.

--Dan Edge

[JMeganSnow]

I think you're blurring the context of an "emergency" here. An emergency of the type where a lie might actually make a difference is when a building has fallen on someone and severed their leg and they're going to bleed out in sixty seconds if you don't do something. In that context, having a patient that is ranting, trying to sit up, fighting the people applying the tourinquet, etc. is a huge problem, and you can't necessarily just pump them full of drugs to make them behave because that might cause heart failure.

I still think putting your knee on their chest and announcing that they WILL die if they DON'T HOLD STILL is the best thing to do, but I don't like people that get hysterical in a crisis so it's no skin off my nose if they die from their own stupidity. This is probably one of the reasons why it's a good thing I'm not a doctor or EMT.

[dan_edge]

Jennifer,

If you ever find me sprawled out in the office, wounded and frantic, just go get the paramedics. Please don't hold me down and say, "Dan, you are going to die very soon unless you calm down! You're dying! You're going to die! You're mere moments from death, fool! Say hello to my great-great-grandmother for me! Except that there's no afterlife; your existence will just end, and very soon! Chill, dead boy!"

--Dan Edge

[JMeganSnow]

I think the first thing I'll do will be to ask, "how did you manage to do that with a stapler?"