Ethics Survey: Intro & Truth-telling Question

We organised a small ethics survey in preparation for the Ethics and Excellence in Medical Practice Today Conference on the 26th of Jan 2008.

A simple 7 question survey was administered to two groups:

• A set of local churches - during the first 2 weeks of January 08
• The participants of the conference - at the time of their registration

We had a total of 117 church members take the survey - and 34 conference delegates.

The church members represented 7 different congregations in the Thane and Mumbai area. 60% of the participants were women (n=99) and the average age was 37.8 (n=83). 61% of the respondents filled up the Hindi version, while the rest did it in English (n=117).

The conference delegatesfilling the survey included 21 doctors and 13 others involved in health care (n=34) . There were slightly more men (53%) than women participants (n=32), and the average age was 41.3 years. All the delegates were given the English version of the survey.

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The first question of the survey was a inquiry into whether a doctor should communicate "bad news" to a patient against the wishes of the patients relatives.

The question was phrased like this:

A patient is diagnosed with an aggressive cancer. The relatives of the patient ask the doctor not to tell the patient what his real condition is and just say that he is sick and will get better. The doctor does not do this, but explains the situation to the patient. Did the doctor do the right thing?

The results were as follows:

Church members generally felt that the Doctor was right to communicate the truth to the patient, with three quarters of them agreeing or strongly agreeing with the stand.

It is interesting to note, however, that almost 1 in 5 felt that the doctor should do as the relatives request and hide the truth from the patient about their condition.

When compared with the church member responses, the delegates to the conference (n=34) mirrored the opinions of the church members (n=117). Two thirds agreed with the doctor's step, and just over 1 in 5 disagreed.

We can see from the question, most agreed that the doctor was right to communicate difficult news to the patient - even though the relatives had requested otherwise.

Some thoughts:

How much value do we place on truth? How do we communicate difficult issues? When do we over-ride what the care-givers desire?

What the question does not capture is how the news is communicated. Hard facts can be shared in loving ways. The Christ-following doctor and health-care worker have tremendous opportunities to speak truth in love.