How would you answer this tough interview question

[medseek1]

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Describe a situation in which honesty is not appropriate?

 

[scotties123]

your professor asks if he's boring.

 

[pianola]

Instances when a little honesty might be a bad thing:

Have you ever heard a doctor say: "Stop lying to me. It's obvious you smoke. Your teeth are stained, you have cancer of the jaw. You smell terrible. Don't try to tell me you only smoke recreationally."

Or have you ever heard a doctor say: "There's no way in heck you've been monitoring your glucose levels. Look, your UA levels of glucose are OFF-THE-CHARTS."

I mean, obviously you NEVER want to be so crude as that. But also, just in general, it's not necessarily helpful to point out that your patient is blatantly lying to you. Sometimes you have to work around that.

Obviously lying is totally wrong; but your 'honesty' in these situations can really hurt the physician-patient relationship.

 

[tkim]

Describe a situation in which honesty is not appropriate?

When answering honestly endangers your life or someone else's.

Example: If I were a psychiatrist and a patient confided to me that he was going to kill his wife after he left and anyone who got in his way and asked if I was going to call the police after he left. I would, of course, answer 'no' and make the call after he left the office.

 

[Decicco]

Say something to the effect of: You can't always tell the complete truth because a patient has no interest in molecular biology or pathophysiology.

 

[pianola]

Example: If I were a psychiatrist and a patient confided to me that he was going to kill his wife after he left and anyone who got in his way and asked if I was going to call the police after he left. I would, of course, answer 'no' and make the call after he left the office.

Actually, if I'm not mistaken, psychiatrists are required to tell patients at the beginning of the session that they are bound by law to report any behavior that might endanger the patient or others. So before the patient says "I'm gonna kill my wife" he should already be aware that the psychiatrist is bound by law to tell appropriate parties.

Someone correct me if I'm wrong here.

 

[tkim]

Actually, if I'm not mistaken, psychiatrists are required to tell patients at the beginning of the session that they are bound by law to report any behavior that might endanger the patient or others. So before the patient says "I'm gonna kill my wife" he should already be aware that the psychiatrist is bound by law to tell appropriate parties.

Someone correct me if I'm wrong here.

That's Tarasoff II. And that's beside the point in this scenario what was told at the beginning of the session or the doc-pt relationship. This simply answers the question of a situation where you would not be honest. Unless you want to be honest, remind the guy of your responsbility to report threats, and get killed.

 

[p30doc]

does this dress make me look fat?

 

[Depakote]

does this dress make me look fat?

beaten to the punch.

 

[Depakote]

I'm also going to go ahead and say it's ok to sugar coat something for family members after the fact.

If someone died in a lot of pain I'll be ok with saying that we had plenty of medication on board to take care of it or that he/she probably wasn't awake enough to feel it. There's an answer they need to hear and I'll give it to them.

 

[pianola]

does this dress make me look fat?

yes.

 

[lol.psych]

Beyond situations in which telling the truth can directly influence someone to be a danger to hirself(him/herself) or others, and other situations regarding the law (because those aren't interesting or thoughtful answers)

The potential answers to that question are different between cultures. For example, in many foreign nations, it's culturally impermissible to tell someone they have cancer (but you can tell their families... who will most likely hide it from them), not because of any kind of legal issue, but because the culture as a whole believes that people are more likely to die if they accept that they're going to die and act like they're going to die - keep them in good spirits, and they'll more likely improve.

"Does this make me look fat?"
You don't say that to someone. That causes more harm than good.

Think of it in a practical way - what would cause more harm than good? Not just to yourself (in that you're less likely to get slapped in the face after calling your girlfriend fat), but to everyone involved (she won't have a good time tonight, she'll hate herself and you, and "does this make me look fat" is a question to which the most culturally accepted answer is "no, of course not, sweetie." Not saying it's always best to lie, because some relationships are such where "well, maybe you'd look better in something else... this kind of accentuates your cellulite" would be an appreciated piece of advice and not an insult)

If asked this at an interview, PLEASE don't just leave it at "you don't tell someone their lab results are the worst you've ever seen, you put it more lightly." Make it more interesting. Don't be a bland and uninteresting cookie-cutter interviewee.

 

[pianola]

"this kind of accentuates your cellulite" would be an appreciated piece of advice and not an insult.

I would probably stand trial for homicide if a guy ever made that kind of comment to my face.

 

[tkim]

If asked this at an interview, PLEASE don't just leave it at "you don't tell someone their lab results are the worst you've ever seen, you put it more lightly." Make it more interesting. Don't be a bland and uninteresting cookie-cutter interviewee.

Better yet, cut to the heart of the question, which is asking you this: Is it ever permissible to lie?

Some people say the sometimes it's okay to lie in order to prevent harm to oneself or others. But what's your definition of harm, and how much avoidable harm would it take to tell a lie?

Conversely, how much of a lie would you tell in order to prevent harm? The question seeks to flesh out your personal ethical framework and how it compares to societal mores. If you say it's okay to lie in order to prevent harm, then one could invoke a slippery slope argument that there might be a situation where telling a very large lie in order to prevent a very minimal harm would be justified.

We do this all the time, but we have our personal limits. What are yours? That's question.

It's not a tough question if you know yourself and are willing to answer honestly.

I was asked this question during one of my interviews. Basically, I was posed the question of being stuck on a remote island with no medical help and someone had been in an accident and was going to die. If that person asked me, would I tell them that?

I answered that I would not tell that person that they were dying. The answer shocked both interviewers. They hammered at me about my answer. "Don't you think he needs to know the truth? Don't you think he needs to prepare himself?" My answer was that he was going to die, there was nothing anyone could do about it, and giving the man hope was more important than telling the truth. I've since revised my opinion, and would tell the guy the truth now, because I realize that not telling him wasn't giving hope - it was giving false hope. I always wondered about that question - clearly both interviewers disagreed with my answer. But I stuck to my answer, didn't waver. Got in off waitlist, didn't end up going there, but I always wonder if I had answered the way they wanted me to, whether it would have been an outright acceptance versus via waitlist.

 

[jeaneous]

Describe a situation in which honesty is not appropriate?

This interview. . .

 

[Law2Doc]

Describe a situation in which honesty is not appropriate?

Lots of possibilities. First, there are the questions you aren't allowed to answer. Not sure if that is dishonest, but you won't be answering the question. Such as if a friend of a patient asks you -- do they have cancer? You aren't allowed to say under HIPAA. Or if a parent asks you about your young teenage patient -- is she having sex? In both these cases you can't openly answer, but have to deny answering in a way that isn't itself an answer.

In psych, it's often suggested that you neither dispute nor validate the delusions of a patient, so again you aren't going to try to impress the truth onto such a patient.

When you are doing a procedure on a patient, eg an NG tube or a blood draw, it's often common parlance to tell them "this won't hurt, it will just feel uncomfortable". That isn't always true. Sometimes it hurts.

And in some cases, you probably should avoid giving opinions -- eg when a patient who is on the fence between two equally risky options asks you "what should I do?"

 

[ar2388]

Beyond situations in which telling the truth can directly influence someone to be a danger to hirself(him/herself) or others, and other situations regarding the law (because those aren't interesting or thoughtful answers)

The potential answers to that question are different between cultures. For example, in many foreign nations, it's culturally impermissible to tell someone they have cancer (but you can tell their families... who will most likely hide it from them), not because of any kind of legal issue, but because the culture as a whole believes that people are more likely to die if they accept that they're going to die and act like they're going to die - keep them in good spirits, and they'll more likely improve.

"Does this make me look fat?"
You don't say that to someone. That causes more harm than good.

Think of it in a practical way - what would cause more harm than good? Not just to yourself (in that you're less likely to get slapped in the face after calling your girlfriend fat), but to everyone involved (she won't have a good time tonight, she'll hate herself and you, and "does this make me look fat" is a question to which the most culturally accepted answer is "no, of course not, sweetie." Not saying it's always best to lie, because some relationships are such where "well, maybe you'd look better in something else... this kind of accentuates your cellulite" would be an appreciated piece of advice and not an insult)

If asked this at an interview, PLEASE don't just leave it at "you don't tell someone their lab results are the worst you've ever seen, you put it more lightly." Make it more interesting. Don't be a bland and uninteresting cookie-cutter interviewee.

my grandma told me about a situation like this. I was horrified when i found out that this is done and made me realize how removed i am from aspects of my culture and how americanized I have become i guess

 

[LostLost]

honesty isn't synonymous with truth.