In a course on first aid I once took, my teacher strongly advocated lying to injured victims in an emergency. He said that one’s chance of survival was strongly tied to one’s hope and confidence that he will survive. Therefore, no matter how awful the victim looks, or how likely you think they are are to die, you should assure them that they will be fine, that their injuries are minor, and so on. Is this unethical?
My current position: it isn’t. Lying is unethical only insofar as it is an act of communication. In this case, lying is a therapeutic act. Or, equivalently, the victim of a serious injury is incapable of being rational, so in a sense you cannot lie to them, in the same way you cannot lie to a dog (you can mislead or confuse a dog, such as by giving him a piece of styrofoam shaped like a bone, but this is not a lie). When you are seriously injured you begin to act quasi-instinctively, and so the standards of interaction designed for rational beings no longer apply.
My first reaction was to simply say: “Okay if you lie to them their chance of survival increases.”
Simple decision.
On the other hand this encourages an attitude that “I know better than you do what is good for you,” which is immoral, as well as the kind of thinking that encourages big government.
My second reaction was to say: “Everyone should have the right to make their own autonomous decisions, and have no one else secretly making decision for them.”
So you should tell them.
Now my third reaction is to say: “Okay, this is first aid. On a purely physical level we expect the provider of first aid to do things for wounds and so on without consulting the patient, and asking for their input. The first aid provider does what is necessary to promote the survival of the patient. If it is necessary to lie to them, then that is fitting with the other medical help they provide.”
So lying would seem legitimate within the context of the emergency situation.
In a course on first aid I once took, my teacher strongly advocated lying to injured victims in an emergency.
In my EMT class, what was stressed was calming the patient/victim down, assure them that they are now in good hands, and that you will do everything you can to get them to the hospital, where the best possible care can be given to them. Most of the time, EMT’s or Paramedics give oxygen to a patient as well, which comes from a mask. They aren’t as talkative or asking questions like, “Am I going to make it?” when that thingy’s on them. You can even say, “It’s going to be okay, we’re going to get you to the hospital…” Or making them answer your questions, instead of allowing them time to ask theirs…at least curbing the ones like the above question. Situations vary obviously…it’s best to be taught by instructors that have actually been on the trucks, at the stations, etc. I don’t know if your teacher has experience, or what class you are in…but that’s how I was being taught, basically. There are specific sections in EMT-training books directed towards this, but I don’t remember mine “strongly” advocating lying…
Here’s another I just thought of…
“Am I going to make it, am I going to live?” victim asks, right before I put an oxygen mask on…
“You’re living through it right now…” i’d say, while putting the mask on her or him…
Lying to the patient like that is wrong in the same way it is for a doctor to lie to a patient. The patient has the same rights regarding first aid as they do involving medical treatment, i.e., the right to refuse treatment, which presupposes the right to knowing what is being done to them, what has happened to them, and what their chances of recovery are. I was taught in first aid classes that it is unethical to lie to patients for that reason and I agree with them. Besides, lying is not necessary to calm them. It is quite possible to calm them without lying. Unless they become extremekky irrational, but that does not justify you lying to them, as they still have a right to the truth regarding their bodies.
I think you should be honest with the person. If his chances of survival are good, then tell him that. Let him adjust to the idea that he will make it. But if his chances are not good, then you should tell him the truth. If someone lied to me and told me I would be okay but I really wouldn’t, I’d never get to say the things and do the things I might have the last chance to say and do.
Here is a good and relevant post from the thread SoftwareNerd linked to:
Respect for the dying can rightfully entail such things as not making accusations (it won’t accomplish anything), but the fact that someone is dying does not entitle them to have reality rearranged to satisfy their whims. What kind of respect for a human being is THAT?!
I would agree with that and would say that the fact that the patient is injured does not give the pateint entitlement to have reality rearranged to satisfy their whims. Lying to them in the way you suggest is merely a form of whim-worshipping. You are worshipping their desire to have reality rearranged to their whims, which you should never do. As JMeganShow says, that is no respect for the human being, especially the patient that wants the truth from you instead of your lies.
I think it is not only fine, but morally obligatory for doctors to lie to patients in emergencies if doing so increases the patients’ chance of survival.
Lying is normally wrong because it does damage to one’s ability to deal with reality, but in a life-or-death emergency situation, lying is a medical measure that recognizes the fact that the stress of knowing the truth could kill someone (the patient should be told the truth once the crisis is over).
Incidentally, doesn’t Ayn Rand say something on this subject in Ayn Rand Answers?
I think it is not only fine, but morally obligatory for doctors to lie to patients in emergencies if doing so increases the patients’ chance of survival.
Lying is normally wrong because it does damage to one’s ability to deal with reality, but in a life-or-death emergency situation, lying is a medical measure that recognizes the fact that the stress of knowing the truth could kill someone (the patient should be told the truth once the crisis is over).
What if the patient wants to know the truth? As I have already said, they have a right to know what is happening to them.
Furthermore, as JMeganSnow said in that thread, nothing can g=be gained from lying. Lying should only be done to protect what you already have, not to gain a benefit.
He said that one’s chance of survival was strongly tied to one’s hope and confidence that he will survive.
If true, I would like to see the evidence for it.
I can see how one’s positive attitude can play more of a role when it comes to fighting an illness such as cancer - something which is strongly tied to the state of our immune system which can be affected by our psychology but during emergencies, having been considerably wounded?
I personally would not want to be lied to. At any point in my life including while dying I want to stay commited to what is real. I want my ability to deal with reality be respected.
I personally would not want to be lied to. At any point in my life including while dying I want to stay commited to what is real. I want my ability to deal with reality be respected.
Same here. Also, we should not pander to the whims of those that want to fake reality.
I think the doctor’s primary obligation is to save the person’s life, not necessarily be honest to them if he honestly thinks doing so would be a detriment to the primary goal.
I’m inclined to want to live over wanting the truth in such a medical emergency IF it would really make a difference. I’ll deal with being lied to later while I’m still living.
I think the doctor’s primary obligation is to save the person’s life, not necessarily be honest to them if he honestly thinks doing so would be a detriment to the primary goal.
No, the doctor only as an obligation to save a patient if he wants to live. If he does not the doctor has no obligation. It is the patient’s right to decide if he will live or die and that can only rationally be done if he is told the truth, therefore the doctor has an obligation to tell the patient the truth.
I’m inclined to want to live over wanting the truth in such a medical emergency IF it would really make a difference. I’ll deal with being lied to later while I’m still living.
What about both? To me both the truth and living is preferable over one or the other. There is no reason why both cannot occur.
Keeping the context, emergencies, I agree that it is not immoral to lie to a person about their prospects if it is reasonable that keeping hope alive will help keep the patient alive. Your purpose it to help the person survive the trauma, and if you tell them “50% of victims die”, that could very easily cause those mind/body interactions where a person just freaks out (remember, emotions are physical reactions, which might actually kill you). It’s pointless to say that it’s irrational to fear dying when there is a 50% chance of surviving.
That said, lying is okay only when the truth kills. If the patient is irrevocably dying and is psychologically in the place where he can handle the truth without his last minutes on Earth be agony, truth is called for.
I would say that in most cases, the doctor should be entirely honest with the patient, for the reasons say DragonMaci gives.
However, if the doctor beleives that telling the truth will in some way hazard the patients life (assuming that this could be and is the case), and if his primary goal is to save the patients life, then a lie might be justified if it saves the patients life. I would much rather be alive and have to deal with being alive, than dead..and well nothing.
Keeping the context, emergencies, I agree that it is not immoral to lie to a person about their prospects if it is reasonable that keeping hope alive will help keep the patient alive.
A lie would only make a difference to an irrational person, not a rational person. So in lying you are catering top their irrationality. You should never cater to their irrationality like that, regardless of the fact that it might save their lives, which i am highly sceptical about. In very few situations would it make much a difference if it made any at all.
Your purpose it to help the person survive the trauma, and if you tell them “50% of victims die”, that could very easily cause those mind/body interactions where a person just freaks out (remember, emotions are physical reactions, which might actually kill you). It’s pointless to say that it’s irrational to fear dying when there is a 50% chance of surviving.
There are others ways to do that than lying, such as soothing them. In fact soothing them is almost always more efficient.
Besides, as I said the patient has the right to know the truth because without it he cannot make rational decisions about whether or not to accept treatment, which he has the right to refuse.
However, if the doctor beleives that telling the truth will in some way hazard the patients life (assuming that this could be and is the case), and if his primary goal is to save the patients life, then a lie might be justified if it saves the patients life.
I doubt that the truth could ever be a hazard if the person was rational. Besides, what about the refusal of treatment right? Lying breaches that as it makes them unable to rationaly make that decision. That right is the most importsant factor in this debate. And we should not cater to irrationality, even to save the life of the irrational.
I would much rather be alive and have to deal with being alive, than dead..and well nothing.
As I said already, what about both? There is absolutely no reason why it is not possible to do both.
I think it is always wrong to lie to a patient because it breaches the right to refusal of treatment and because there is always a superior alternative.
I think the remarks about “whim-worshipping” and “false reality” ignore the data that would indicate that the patient’s beliefs and state-of-mind do have an effect on their probability of survival.
I think the issue is that telling them they are fine makes it more likely that they will pull through, all other things being equal. Telling them they are not fine lowers the chances of pulling through.
The remarks about “whim-worshipping” assume that patient survival is totally independent of the patient’s state of mind.
In cases like this, as I understand things, the patient’s whims do in fact effect the outcome.
I think the remarks about “whim-worshipping” and “false reality” ignore the data that would indicate that the patient’s beliefs and state-of-mind do have an effect on their probability of survival.
I think the issue is that telling them they are fine makes it more likely that they will pull through, all other things being equal. Telling them they are not fine lowers the chances of pulling through.
But what if the patient does not want treatment or to survive? The patient has the right to make that decision. They need the truth if they are to make an informed and rational decision on that!