Chapter XVII: Truth in Our Intercourse with the Sick, 357

Variety of opinion and practice on this subject. Percival’s views
in his Medical Ethics. Advocates falsehood. Object of this chapter
to present the practical considerations bearing on this subject,
illustrating them with cases. 1. Knowledge concealed from the
patient by falsehood it is wrong to assume would certainly do him
harm if communicated to him. 2. Deception as commonly practised
generally fails to be carried out. Case of the deceived child. 3.
The discovery of the deception, when it takes place, has a worse
effect on the patient than a full statement of the truth could
produce. 4. Destruction of confidence occasioned by discovered
deception injurious to the persons deceived. Children. The insane.
Detected deception not only increases insanity, but modifies it. 5.
_General_ effect of deception, extending beyond the individual on
whom it is practised. General distrust of the veracity of physicians.
6. If adopted as a common rule that deception is sometimes proper,
the object of the deception would be defeated. 7. If the door for
deception be once opened there is no limit. Though proper sometimes
to withhold the truth, wrong to put falsehood in its place. Enquiries
of the sick not always to be directly and fully answered. Too
definite opinions often given by physicians.