Physician Deception and Telling the Truth About Medical “Bad News”: History, Ethical Perspectives, and Cultural Issues

Searight and Meredith review the ethical, clinical, legal, and cultural aspects of deliberate non-disclosure of medical “bad news.” The chapter explains how US norms for physicians’ communication of life-threatening illness to patients have changed over the past 60 years. The authors also discuss how cultural dimensions play a significant role in the disclosure of serious medical conditions. Further, the chapter examines historical examples of physicians writing for the general public and defending non-disclosure, thereby misleading patients that such practices are compassionate and a medical virtue. Searight and Meredith trace the gradual evolution of the norm of patient informed consent from the 1930s to the present and argue that withholding medical “bad news” continues to be a value in some collectivist cultures.