130ff) Keeping him in ignorance "for his own good" is not a doctors job. B would lapse into severe depression on hearing the news.He might, or he might not; and there may be ways of breaking the news that would make a difference. Finally, by not telling him, the doctor risks harming him in other ways: she keeps him from making his own decisions about how to use the next few months, perhaps his last good months; and she damages his trust in her, trust which will be very important as his health deteriorates.He needs to know his condition so that the choice is his, not the doctors.
But this creates, not only a barrier between the physician and the patient, but also a split within the physician herself. It might be argued that, strong as the ordinary case for truth telling might be, there are factors in his situation that make it morally right to withhold the truth.
She seems to be one person when she is with the patient, and another when she is alone or with her peers. The strongest reasons for thinking so are his emotional fragility and the fact that his family support will be much stronger within a month or two: when he and his wife are together and after their daughter has delivered her baby.
This follows from their autonomy: their ability, and therefore their responsibility, to take charge of their own lives.
Although chemotherapy and radiation are not likely to do Mr. He might want to try it, for the slim chance that it would prolong his life somewhat.
But in the end they do not outweigh the case for telling the truth. It might be useful to review the basic moral reasons favoring honesty, and then apply them to this case.
First, patients have a right to decide whether to accept treatment or reject it.
Patients come to physicians when they dont understand whats going on in their bodies or dont know what to do about it.
When someone studies medicine, gets a license, and goes into practice, she implicitly promises to help people understand and deal with their diseases.
But at every step, as the proverb says, she weaves a still more tangled web, drawing others (nurses and technicians) into a complex deception.
The chances of the truth being discovered are always greater. B will probably find out that he was lied to, and that will make it harder for him to trust his doctor.