Lying in emergencies

Ethics
21

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.

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.

Thats the thing, not everyone is ever going to be rationa all the time especially when they are seriously injured or ill. There is a good case for the doctor choosing to lie to the patient if he beleives the alternative is the patients most likely death. I think we can all see which is the best alternative and why this is so.

Lying to prevent a treatment right as you put it, probably woudlnt be justified. But let me try to give an example where lying to him in another case might be:

The patient has some disease, lets call it Illness A. Illness A is treatable by one known method, however the treatment contains a chemical the patient is against taking for some stupid reason (even to the point of death), and the doctor is convinced he will not be able to talk the patient out of his irrational beleif Now the doctor has the choice of allowing the patients paranoia, condemning himself to death , or lyhing to him and saying it deosnt contain the substance if the patient asks and having the patient at least be alive.

Such cases seem far fetched, but I have heard of such happening

Now a case that might apply to a more rational person. This time the treatment is considered based on the results of faulty experiments. The patient has accepted this data, not knowing the so called proof is wrong, its not a matter of irrationality, to his best judgement and knowledge, the experiments are correct. so he beleives and without being irrational that it is indicated the drugs are dangerous and will cause a worth death most likely than the illness.

Now the doctor however has objective proof that the experiments are wrong, it doesnt cause any significant harm, and should save the patients life. Now he doesnt have time to convince the patient that he is right, the proof is long and complicated, and he doesnt expect the patient will beleive his mere claims, as the patient beleives that he has proof that the treatment will kill him, and he deosnt want to die a worse death. So the doctor can lie, and say the treatment is something else, and save the patient, or he can let the patient die…he hasnt time to honestly get the patient to take the treatment knowing what is …even though the guy is rational and acting to thie best of what he beleives to be true.

Why is there ALWAYS an superior alternative?

Sometimes it is a matter of letting a patients irratioanl decisions kill them versus lying…I think the first is much worse than the latter. And you cannot say this never happens. And there are other cases involving even more rational people. So your “always” claim is false.

22

Thats the thing, not everyone is ever going to be rationa all the time especially when they are seriously injured or ill.

I am well aware of that, but as I said several times already, we should not cater to the irrational. There is never justification for catering to the irrational.

There is a good case for the doctor choosing to lie to the patient if he beleives the alternative is the patients most likely death. I think we can all see which is the best alternative and why this is so.

Translationh: There is a good case for the doctor to make it so the patient cannot make the decision on whether to live or die on reality, to make it so the decision id based on fantasy instead. Whether you intended it or not, that is the meaning of what you said. The patient always has a right to know the truth in any case.

Lying to prevent a treatment right as you put it, probably woudlnt be justified.

Well, whether you intend it or not, that is what the lie always ends up as.

The patient has some disease, lets call it Illness A. Illness A is treatable by one known method, however the treatment contains a chemical the patient is against taking for some stupid reason (even to the point of death), and the doctor is convinced he will not be able to talk the patient out of his irrational beleif Now the doctor has the choice of allowing the patients paranoia, condemning himself to death , or lyhing to him and saying it deosnt contain the substance if the patient asks and having the patient at least be alive.

That lie still breaches the patient’s right to know what is being done to him. There is no justification to deny the patient the right to know what is being done to him and there can be done.

Now a case that might apply to a more rational person. This time the treatment is considered based on the results of faulty experiments. The patient has accepted this data, not knowing the so called proof is wrong, its not a matter of irrationality, to his best judgement and knowledge, the experiments are correct. so he beleives and without being irrational that it is indicated the drugs are dangerous and will cause a worth death most likely than the illness.

Now the doctor however has objective proof that the experiments are wrong, it doesnt cause any significant harm, and should save the patients life. Now he doesnt have time to convince the patient that he is right, the proof is long and complicated, and he doesnt expect the patient will beleive his mere claims, as the patient beleives that he has proof that the treatment will kill him, and he deosnt want to die a worse death. So the doctor can lie, and say the treatment is something else, and save the patient, or he can let the patient die…he hasnt time to honestly get the patient to take the treatment knowing what is …even though the guy is rational and acting to thie best of what he beleives to be true.

Again the patient’s right to know what is being done to him.

Why is there ALWAYS an superior alternative?

Because regardless of intent, lying to the patient always results in breaching his right to know what is being done to him.

Sometimes it is a matter of letting a patients irratioanl decisions kill them versus lying…I think the first is much worse than the latter. And you cannot say this never happens. And there are other cases involving even more rational people. So your “always” claim is false.

If the patient dies, even because it is of a irrational decision, it is of their choice and no one has the right to countermand that choice under any circumstances.

And thus I have just illustrated how my “always” claim is not false. because there is never justification for countermanding the patient’s decision to die and nev er justification for breaching the patients right to know what is being done to them.

23

I am well aware of that, but as I said several times already, we should not cater to the irrational.

So a doctor should allow a patient, whom for all he knows is usually rational to die? What if he knows the guy is normally very ratonal, but is succumbing to irrationality due to the severe stress of severe illness / injury? Should he apply this e ven then and let him die? If we take what you say literally, and what other way should we take it: YES. I strongly disagree with that.

Translationh: There is a good case for the doctor to make it so the patient cannot make the decision on whether to live or die on reality, to make it so the decision id based on fantasy instead. Whether you intended it or not, that is the meaning of what you said. The patient always has a right to know the truth in any case.

That is not a valid translatioin, and not what I said. Sure, it might voilate his rights, but is it better to DIE than to have your rights violated even if so? Should the doctor beleive the patient would prefer DEATH over having his rights violated? I dont think so, most sane people would rather be lied to have their rights violated than to die. This is an emergency situation, moral issues like these are absolutes never to be breached, in non-emergency situations. But in matters of life and death, it is sometimes better to commit what would normally be immoral than allow yourself to die or others to die.

If you refuse to understand this, then that is your problem, and I will not debate it. Go read up on things a bit more before you try to debate that issue. You will hopefully find out you are wrong.

edit: If the patient clearly wants to die: thats another matter…

24

So a doctor should allow a patient, whom for all he knows is usually rational to die? What if he knows the guy is normally very ratonal, but is succumbing to irrationality due to the severe stress of severe illness / injury? Should he apply this even then and let him die? If we take what you say literally, and what other way should we take it: YES. I strongly disagree with that.

It is the patient’s decision and he has no right to override it, so yes. If he override the patient’s decision he would be breaching the patient’s rights, so yes.

That is not a valid translatioin, and not what I said. Sure, it might voilate his rights, but is it better to DIE than to have your rights violated even if so? Should the doctor beleive the patient would prefer DEATH over having his rights violated?

You are trying to justify a breach of right? That is pretty immoral and evil of you. There is never justification for rights breaches. You yourself have said as much.

I dont think so, most sane people would rather be lied to have their rights violated than to die.

Sane people would rather prefer the truth and not dying over one or the other.

This is an emergency situation, moral issues like these are absolutes never to be breached, in non-emergency situations. But in matters of life and death, it is sometimes better to commit what would normally be immoral than allow yourself to die or others to die.

Tranlation: subjective morals as opposed to onbjective morals.

If you refuse to understand this, then that is your problem, and I will not debate it. Go read up on things a bit more before you try to debate that issue. You will hopefully find out you are wrong.

Nope, I am not wrong. Breaching rights is always immoral and evil and you are sanctioning the immroal and evil. Rights violations are never justified because rights are only lost when you breach the rights of others. In almost all cases the patients has not done so, so you must respect their rights, unless they breach rights, in which case there is no rights to breach.

25

You dont understand, Im not trying to justify it as such, its horrible, it might be a terrible breach of their rights, but if one beleives death is the only option, then I do not think it is evil to choose that over death. I am saying that given the choice of that or allowing one to die, it is prefferable. Can you not see this?

26

You dont understand, Im not trying to justify it as such, its horrible, it might be a terrible breach of their rights, but if one beleives death is the only option, then I do not think it is evil to choose that over death. I am saying that given the choice of that or allowing one to die, it is prefferable. Can you not see this?

No, I do not, as the patient as a right to life and the right to life includes the right to end it. And no one has the right to deny them that right.

27

They do have the right to end it. The doctor isnt changing that. He is merely trying to take actions that prevent him dying in one way. NOthing stops the patient (assuming any action is open to him at all) ending his life. Now granted the patient can completely refuse any and all treatment, and not deal with the doctor at all, or at least he should have this option.

If the patient wants to die..thats fine..he has the right..but im assuming he wishes to live.

28

Now granted the patient can completely refuse any and all treatment

Exactly! That is the sort of situation I am referring to! My point is that if the doctor lies to him he cannot base such a decision of=n reality, only on fantasy, and so lying to the patient is wrong, as it denies him the ability to base such a decision on reality instead of fantasy. Now do you see what my point is? Or are you going to get it wrong again?

Besides as for the lying to help them live crap, neither you nor anyone else has addressed my point about rational patents prefering both turth and life that i made several times. Is that because you all know that it is a valid argument that cannot be rationally refutted?

29

Ok, sum up those points if you will…perhaps I will address them.

Exactly! That is the sort of situation I am referring to! My point is that if the doctor lies to him he cannot base such a decision of=n reality, only on fantasy, and so lying to the patient is wrong, as it denies him the ability to base such a decision on reality instead of fantasy. Now do you see what my point is? Or are you going to get it wrong again?

Besides as for the lying to help them live crap, neither you nor anyone else has addressed my point about rational patents prefering both turth and life that i made several times. Is that because you all know that it is a valid argument that cannot be rationally refutted?

Any and all treatment would be refusing to deal with the doctor or anyone else offering treatment. But if the patient prefers treatment, ie he wants to live but his choices of offered “treatments” will kill him, then its still preferable for those trying to treat him to lie to him if it will save his life. You have provided no explanation as for why allowing him to die is prefferable, even given “a violition of rights”.

30

Ok, sum up those points if you will…perhaps I will address them.

OK, here they are:

  1. A rational person would prefer to know both the truth and live. Do you agree with that?

  2. That if you lie to a patient then any decision they make is based on fantasy rather than reality. I assume you agree with that.

  3. If their decisions are based on fantasy rather than reality then their ability to make that decision rationally removed.

  4. What right does the doctor have to impair the patient’s ability to make rational decisions on treatment? I would argue none.

  5. If they have no such right then they should not lie, as they are contradicting the principle of letting people make their own decisions, as if you are not truly allowing them to do that, as you lie scewers their decision.

Is that clear enough for you?

31

No, the doctor only as an obligation to save a patient if he wants to live.

Sure, but my statement presumes the person wants to live. Yes, if he would prefer to die, well it doesn’t matter what the doctor tells him. So since we can contort this emergency room situation any way we want, the person who wants the truth and prefers to die when the alternative could otherwise cause them to live and make a full recovery is being irrational.

I’m not sure how much you deal with people in medical traumas, say like gunshot wounds or stabbings and the like, but otherwise rational people don’t always behave rationally under such situations. Just because they don’t act rationally in such an emergency situation does not make them irrational people.

However, I’m speaking for myself. I have no need to convince you how to think or handle a situation if you are the one laying on the emergency room table. By all means, handle that situation however you think is best for your life. I hope you never have to face such an emergency, and if you do I hope you can think rationally throughout it.

  1. A rational person would prefer to know both the truth and live. Do you agree with that?

You just don’t seem to understand or have any experience in dealing with people in trauma. Otherwise rational people can behave very irrationally when subject to traumatic injury. This is NOT a clear-cut yes answer, it depends on a specific context.

Is that clear enough for you?

32

OK, here they are:

  1. A rational person would prefer to know both the truth and live. Do you agree with that?

  2. That if you lie to a patient then any decision they make is based on fantasy rather than reality. I assume you agree with that.

  3. If their decisions are based on fantasy rather than reality then their ability to make that decision rationally removed.

  4. What right does the doctor have to impair the patient’s ability to make rational decisions on treatment? I would argue none.

  5. If they have no such right then they should not lie, as they are contradicting the principle of letting people make their own decisions, as if you are not truly allowing them to do that, as you lie scewers their decision.

Is that clear enough for you?

lets assume the patient wants to live, and wants treatment. he is free at any time to refuse to deal with the doctor, or go elsewhere, or to kill himself in whatever way he can and chooses. If he is a vegetable, he has the full right to refuse any treatment or means of prolonging his life, which then would allow him to die (possibly very quickily).

  1. Well, no I think a ratonal person would rather they were alive and lied to. Now, as I said, dont lie to the rational person unless there is good reason to beleive the only option is their death. But ask rational men, I think they would prefer to be lied to and live than to die, and would grant taht the doctor made the right choice to lie as it saved his life at least. I think its grossly irrational to prefer to die than to be lied to..

  2. I would agree with this, but it might be possible that you dont have the time to present the truth, or for some reason you cannot tell it, but a lie is neccessary to save their life. Granted this is very u nlikely and rare, but assuming the situation could and did arise where telling them the truth would somhow kill them, if you value their life, then its better to let them live, even if misinformed than to tell them the truth and then have them die.

  3. Isnt it better to live and be misguided than to know the truth for a moment then to die? These are al emergency situations, the optiosn are between the what woudl normally be things that should never be allowed, ie lies, or knowing the full truth or death. Its better to be alive and to beleive a fantasy than to be DEAD.

4 (im going to put 5 in here, as its sorta related) =>

This is not a matter of “does he have the right” as such, it is a matter of does he beleive that the patients “rights” are more important than the patients life. Why on EARTH would the doctor beleive the patients death is prefferable to “Breaching the patients rights”? Remember, we are assuming the patient wants to live, which is a reasonable assumption, if the patient wants to die, if he wants to de he should make it clear. If he tells the doctor “If its a matter of my rights of death, let me die” well, oK maybe the doctor should respect that, but the patient woudl be insane to say that.

I dont think I can make this any more clear…if you dont get it , then I dont t hink I care to try explain it anymore.

33

But what if the patient does not want treatment or to survive?

Wouldn’t the patient have an obligation to say so?

If the patient says “I don’t want surgery if the chance of survival is less than 20%”, and the doctor lies in saying that an impending operation has greater than 20% chance of survival, I agree with you.

But if the patient doesn’t say such a thing (i.e. “I don’t want X under conditions Y”) and the doctor doesn’t know of the unstated conditional, I don’t see precisely why the doctor has the obligation to truthfully tell the patient what the chance of survival is - even if the patient asks what the chance of survival is.

34

Besides as for the lying to help them live crap, neither you nor anyone else has addressed my point about rational patents prefering both turth and life that i made several times. Is that because you all know that it is a valid argument that cannot be rationally refutted?

First, it’s not crap. There’s no need to escalate the tone of this conversation to one that it hostile. Second I didn’t specifically address it because it is not a point that wins the argument, it’s simply one possibility in any number of varying contexts. What a rational person may “prefer” and what the outcome may be can be two very different things.

35

You just don’t seem to understand or have any experience in dealing with people in trauma. Otherwise rational people can behave very irrationally when subject to traumatic injury. This is NOT a clear-cut yes answer, it depends on a specific context.

Is that clear enough for you?

Yes, but the person is still better off with the truth and life than a lie and life. My point is that knowing the truth and living is superior to living and being lied to. Besides, in lying to them you are saying they are incapable of handling the truth, which is insulting.

lets assume the patient wants to live, and wants treatment.

Then there is no need to lie to them since they want. Besides, I was not talking ab out such people. I was talking about either: a) people that want to die, or, more importantly, B) people that want to live, but do not want a particular treatment. How are they to properly make such a decision if they are told a lie instead of the truth?

he is free at any time to refuse to deal with the doctor, or go elsewhere, or to kill himself in whatever way he can and chooses.

Yes, but I refer you to the question above.

If he is a vegetable, he has the full right to refuse any treatment or means of prolonging his life, which then would allow him to die (possibly very quickily).

And if he isn’t a vegetable? Does he still have that right?

  1. Well, no I think a ratonal person would rather they were alive and lied to.

Why the hell would anyone prefer a lie and life over the truth and life?

Now, as I said, dont lie to the rational person unless there is good reason to beleive the only option is their death.

I very much doubt the a lie would save someone and that the truth and life would not be possible.

I think its grossly irrational to prefer to die than to be lied to..

I never said anything about prefering the truth and death. I said the truth and life. There is nothing irrational about preferrong the truth and life. It is in fact quite ratiuonal.

  1. I would agree with this, but it might be possible that you dont have the time to present the truth, or for some reason you cannot tell it, but a lie is neccessary to save their life. Granted this is very u nlikely and rare, but assuming the situation could and did arise where telling them the truth would somhow kill them, if you value their life, then its better to let them live, even if misinformed than to tell them the truth and then have them die.

I am _ extremely _ doubtful that this has ever happened or could ever happen. If you could provide me with even one case of it I would be extremely surprised, but I doubt you can do that.

  1. Isnt it better to live and be misguided than to know the truth for a moment then to die?

How many times do I have to say I was not talking about preferring truth over life, but that I was talking about preferring _ BOTH _? At least half a dozen so far, and it still has not sunk in yet. I am starting to doubt it ever will.

This is not a matter of “does he have the right” as such, it is a matter of does he beleive that the patients “rights” are more important than the patients life. Why on EARTH would the doctor beleive the patients death is prefferable to “Breaching the patients rights”?

Life without rights is meaningless, so it is it not a matter of which is preferable, but the fact that the two go hand-in-hand. You cannot truly have one without the other. The doctor must act cosnsistent with this if he is to be onjective, so he should never breach the patient’s rights. _ EVER _. Period. End of story.

Remember, we are assuming the patient wants to live.

No, you are, I am not, so “we” is incorrect. I am neither assuming he wants to live or that he wants to die. I am talking either he wants to die or he wants to live but not than ks to the use of a particular treatment. Sometimes there are good reasons to refuxe particular treatments, but _ ONLY _ if one is told the truth about them.

“If its a matter of my rights of death, let me die” well, oK maybe the doctor should respect that, but the patient woudl be insane to say that.

Insane? No, sometimes there are good reasons to want to die. Maybe you have some value in life left to you in life, but not enough to justify a particular treatment. The thing is if you are lied to you cannot rationally make such a decision.

I dont think I can make this any more clear…if you dont get it , then I dont t hink I care to try explain it anymore.

I get it, I just don’t agree.

Wouldn’t the patient have an obligation to say so?

Yes, but if lied to the decision that lead to that statement is not based on reality, as it should be.

First, it’s not crap. There’s no need to escalate the tone of this conversation to one that it hostile. Second I didn’t specifically address it because it is not a point that wins the argument, it’s simply one possibility in any number of varying contexts. What a rational person may “prefer” and what the outcome may be can be two very different things.

Firstly, I was not being hostile, I was stating an opinion. My opinion is that it is crap for the reasons I have given in this post. That is far from hostility. Secondly, I never said it won an argument, only that no one addressed it, even though it was an impoartant part of my point.

36

[Argument between me and DragonMaci was taken into another medium outside the forum and mostly resolved at this point.]

Man, yet again another emergency based thread ends up long and heated :-P. Phew..how many is that now?

37

[Argument between me and DragonMaci was taken into another medium outside the forum and mostly resolved at this point.]

Man, yet again another emergency based thread ends up long and heated. Phew..how many is that now?

Who was heated? I did not notice it.

As for the debeate being moved, well it is mostly settled now. It just has a few minor issues to be settled.

38

Well I edidte the post to make it clear that I was exaggreating that a little. But such debates I have noticed often end in / contain very long and often heated debates, but I guess that is to be expected.

39

Well I edidte the post to make it clear that I was exaggreating that a little. But such debates I have noticed often end in / contain very long and often heated debates, but I guess that is to be expected.

Yeah, some people just like to debate endlessly in heated tones sadly.

40

Yes, but the person is still better off with the truth and life than a lie and life. My point is that knowing the truth and living is superior to living and being lied to.

But it’s NOT better if telling the truth is something that ultimately causes them to die because they can’t handle it due to their traumatic state. The person who wants to live is better off living whether it took a lie or the truth so the “superior” case is contextual to the circumstances.

Besides, in lying to them you are saying they are incapable of handling the truth, which is insulting.

It’s not insulting in the least to recognize that in reality they can’t handle the truth because of the traumatic state of mind they are in. It’s a recognition of reality on the doctor’s part when the patient is otherwise not capable or dealing with reality. Think of it as being analogous to being given anethesia for surgery. Would you want the full “reality” pain of being sliced open on the operating table or would you rather have the “fantasy” of drugs to block the pain? That’s rhetorical, you don’t have to answer it. At any rate, I’ll take being insulted then ultimately living rather than being respected and dying (within the context under discussion).

I don’t fault you for your logic or adherence to principles in your opinion. Where I think your position is lacking is in knowledge of dealing with people in emergency medical conditions and the possible state of mind they can be in. You appear to deny that otherwise rational people can legitimately be in a different state of mind when they are experiencing some significant medical emergency. I’d be willing to bet you have little to no experience in actually dealing with people who are suffering from significant burns, compound fractures, stab wounds, gunshot wounds, internal injuries from car accidents, etc. etc. I know factually that otherwise rational people can be in a different state of mind in such instances. It isn’t a matter that they might otherwise prefer to live and be told the truth, it’s a matter that their current state of mind is affected by their current medical emergency and they aren’t dealing with it well. This is a perfectly normal human reaction.

That said, I’ve laid out my position all I care to. If you are unpersuaded, so be it.