Would you lie to a patient interview question?

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I have no idea what a patient interview question is.
 
My title was poorly punctuated. If you received the question, "would you lie to a patient, and if so in what circumstances? in an interview how would you answer it?
 
If a patient asked me a very personal question (like, where do you live? have you ever had sex in this position?) and I couldn't simply evade the question, I would consider lying.
 
Here is a hint, people with integrity don't lie.

And you certainly don't admit to lying to patients in an interview.
 
rHinO1 said:
Here is a hint, people with integrity don't lie.

And you certainly don't admit to lying to patients in an interview.
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Couldn't saying that you would never lie to a patient be seen as a lie? A catch 22 of sorts?
 
Keem said:
Couldn't saying that you would never lie to a patient be seen as a lie? A catch 22 of sorts?
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No, b/c I really won't lie to my patients. My job as a doctor is to provide truthful/accurate information to my patients, and help them make good decisions. My job is not to mislead or lie to them.

Don't over think it.
 
rHinO1 said:
No, b/c I really won't lie to my patients. My job as a doctor is to provide truthful/accurate information to my patients, and help them make good decisions. My job is not to mislead or lie to them.

Don't over think it.
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Patient calls you for lab information which is very disconcerting to you (malignancy). Its a day or two before the holidays. Do you ruin the holiday or tell them it hasn't come back yet?
 
Bacchus said:
Patient calls you for lab information which is very disconcerting to you (malignancy). Its a day or two before the holidays. Do you ruin the holiday or tell them it hasn't come back yet?
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I tell them the truth. Not my place to decide when a patient deserves to know their results. Maybe they want to be surrounded by family while they are dealing with the news, and since it is the holidays they have people with them.
 
Bacchus said:
Patient calls you for lab information which is very disconcerting to you (malignancy). Its a day or two before the holidays. Do you ruin the holiday or tell them it hasn't come back yet?
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+1

What about a patient with dementia thinking a situation is something else (in a positive way) do you bring them down with the truth? Do you not say anything (basically the same thing as lying)? Do you play along?
 
Bacchus said:
The problem is, you wouldn't give such results over the phone. Lipid profile is a bit different than tumor markers.
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I have been present multiple times when different doctors have told a patient they have cancer over the phone.
 
Bacchus said:
The problem is, you wouldn't give such results over the phone. Lipid profile is a bit different than tumor markers.
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Ok, I'll remember that.

Anyways, I am confident sticking to principles of integrity and honesty will work out well in an interview, and in life. It got me an acceptance following my mmi interviews, which consisted mostly of ethical scenarios.

You can make up all the scenarios you want, but my answer won't change. Just trying to help you out op, but you oviously need to figure it out for youself and go with what you think is right.
 
Re dementia patient: if they have a POI and are not competent, you can withhold info -- never lie.

Same goes with personal questions: you can easily avoid answering.
 
This is a common topic in medical ethics. There are certainly situations in which you are allowed to withhold information. However, outright lying is wrong. Such is the magic if manipulating your language and words.
 
There's a difference between having principles and applying said principles to every scenario unequivocally. As a medical professional you're not just a purveyor of your patient's information but you're also their advocate and you look out for their best interest. You can't just say my principles dictate X therefore I will do X without considering the impact that has on your patients quality of life. Tact and judgement are also components of the profession.
 
getdown said:
There's a difference between having principles and applying said principles to every scenario unequivocally. As a medical professional you're not just a purveyor of your patient's information but you're also their advocate and you look out for their best interest. You can't just say my principles dictate X therefore I will do X without considering the impact that has on your patients quality of life. Tact and judgement are also components of the profession.
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Definitely true, but you can also use tact and judgement without resorting to lying. I wouldn't say there are absolutely zero scenarios in which lying is appropriate, but I can't really think of any after some thought. Regardless, it's close enough to zero, especially for the purposes of an interview question.
 
getdown said:
There's a difference between having principles and applying said principles to every scenario unequivocally. As a medical professional you're not just a purveyor of your patient's information but you're also their advocate and you look out for their best interest. You can't just say my principles dictate X therefore I will do X without considering the impact that has on your patients quality of life. Tact and judgement are also components of the profession.
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I completely agree that tact and judgement apply. And of course, we must consider the impact of our actions on our patients' quality of life. As a patient's advocate, it is important to assist them in making their own decisions, and not excluding them from the process by exclusively making choices for them.
 
To answer OP's question: there are certain times and places were lying is the right thing to do. Let's just accept that as fact.
 
I basically had this same ethical dilemma in my Georgetown interview. The interviewer had us roleplay that my patient told me that he would give up on health care forever if I made an error, but that in the process of treating him I did make an error. Would I tell the truth about the error, my interviewer asked me?

I told the truth, and explained that it was important in order to preserve doctor-patient trust. Apparently that was the wrong answer, because I got rejected there :laugh:
 
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WholeLottaGame7 said:
What is a white lie? What lies don't harm anyone? Pretend I'm your interviewer. Isn't that what this thread is for?
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Ok...

Someone who tells a lie to save someone's life or protect someone's life has a valid reason to tell a lie. There are times in which lying is necessary. An extreme example would be telling a terminally ill patient that they're probably going to die. I would instead try to encourage hope while still trying to be straightforward. Lying for the sake of the patient and saying that it is possible to survive despite all medical proof is something I would be willing to do.

That's how I'd respond to that question.
 
Geneticist said:
Ok...

Someone who tells a lie to save someone's life or protect someone's life has a valid reason to tell a lie. There are times in which lying is necessary. An extreme example would be telling a terminally ill patient that they're probably going to die. I would instead try to encourage hope while still trying to be straightforward. Lying for the sake of the patient and saying that it is possible to survive despite all medical proof is something I would be willing to do.

That's how I'd respond to that question.
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Lying is never necessary, you're pointing out that in certain instances it could be more beneficial than the truth and in that sense lying often times seems like a good option.

Necessary, no it is not. Remember this argument has been moved to semantics, you aren't keeping up.
 
Geneticist said:
Ok...

Someone who tells a lie to save someone's life or protect someone's life has a valid reason to tell a lie. There are times in which lying is necessary. An extreme example would be telling a terminally ill patient that they're probably going to die. I would instead try to encourage hope while still trying to be straightforward. Lying for the sake of the patient and saying that it is possible to survive despite all medical proof is something I would be willing to do.

That's how I'd respond to that question.
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That's certainly a very valid response, but I don't see how either of those are lies.
 
Mithril said:
I don't agree with this. It makes physicians assume an inappropriate paternalistic role. The patient, as long as he is competent, should be disclosed information about his health so that he can make an informed decision of how to guide his own care. It's easy to tell one lie; it's hard to tell only one lie.
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I honestly believe that there are certain circumstances where telling a lie would be more beneficial than harmful to the patient. Like I said, an extreme situation would be telling someone who's terminally ill that they still have hope when, despite insurmountable medical evidence, they shouldn't.

Maybe I'm just being an idealist, I don't know. It's certainly a valid question and I'd be stumped as to how to answer it on the spot during an interview. Let's just hope that doesn't happen. 👍
 
Geneticist said:
Ok...

Someone who tells a lie to save someone's life or protect someone's life has a valid reason to tell a lie. There are times in which lying is necessary. An extreme example would be telling a terminally ill patient that they're probably going to die. I would instead try to encourage hope while still trying to be straightforward. Lying for the sake of the patient and saying that it is possible to survive despite all medical proof is something I would be willing to do.

That's how I'd respond to that question.
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encouraging hope =/= lying (necessarily)
 
WholeLottaGame7 said:
That's certainly a very valid response, but I don't see how either of those are lies.
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Just to play Devil's advocate a little...

Let's just say disease X has a 100% mortality rate. Patient A has disease X and isn't expected to live for more than a week. Would you be willing to tell Patient A that they are, without a doubt, going to die? Or would you instead try to instill hope and encourage them to survive by telling them that it is possible to survive despite medical evidence? I'd be willing to lie.
 
No, I would not lie.

1) the patient has the right to know what's going on. We do not have the authority to decide which information the patient can handle. I think that's insulting to their intelligence.

2) the patient has autonomy, but they can not make decisions about their health without the truth.

3) I had a good 3rd point, but I've forgotten it. So, i'll just say don't lie because your mother has taught you better.
 
Geneticist said:
Just to play Devil's advocate a little...

Let's just say disease X has a 100% mortality rate. Patient A has disease X and isn't expected to live for more than a week. Would you be willing to tell them that or would you instead try to instill hope and encourage them to survive by telling them that it is possible to survive despite medical evidence? I'd be willing to lie.
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Are you kidding? 100% mortality rates absolutely means death is certain.

You haven't taken Stats I suppose, but if somebody has a disease with a 100% death rate, they are certainly going to die.

Maybe you should rephrase it to 99.9% mortality rate because I think that is the case you are trying to build.

To tell a patient in that scenario they aren't facing certain death is unethical and wrong, it isn't just the patient... You'll have an entire family devastated and you need to make the prognosis real to everybody involved.
 
BDIX727 said:
Are you kidding? 100% mortality rates absolutely means death is certain.

You haven't taken Stats I suppose, but if somebody has a disease with a 100% death rate, they are certainly going to die.
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Obvious cat is obvious.

BDIX727 said:
Maybe you should rephrase it to 99.9% mortality rate because I think that is the case you are trying to build.

To tell a patient in that scenario they aren't facing certain death is unethical and wrong, it isn't just the patient... You'll have an entire family devastated and you need to make the prognosis real to everybody involved.
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Telling a white lie to instill confidence in an otherwise hopeless patient is something I'd be willing to do. That's all I was trying to say. Didn't mean to offend... 🙂
 
Geneticist said:
Just to play Devil's advocate a little...

Let's just say disease X has a 100% mortality rate. Patient A has disease X and isn't expected to live for more than a week. Would you be willing to tell Patient A that they are, without a doubt, going to die? Or would you instead try to instill hope and encourage them to survive by telling them that it is possible to survive despite medical evidence? I'd be willing to lie.
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this isn't lying imo. i don't know if i would ever make an absolute claim that the patient is going to die. medical "miracles" happen all the time and defy odds. just because i tell the patient there is a possibility of survival doesn't mean that i am not telling the truth.
 
Outright "lie"? Generally, no, but I have certainly withheld information before; especially when telling something might harm the patient. For instance, in the ED I once had a woman get into a car accident after visiting her husband, who was about to be admitted to the CCU for observation after having an AMI and coming to the ED. The wife had had something to drink on the way home and ended up getting into a wreck (w/ EtOH). As a result, she was both injured and being charged with a DUI. Her husband was conscious but at that moment, it was certainly not a good time to stress him out further.
 
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Mbeas said:
this isn't lying imo. i don't know if i would ever make an absolute claim that the patient is going to die. medical "miracles" happen all the time and defy odds. just because i tell the patient there is a possibility of survival doesn't mean that i am not telling the truth.
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*maybe* I chose a poor example to represent what I was trying to get at...
 
Mithril said:
If we're assuming that this patient is certainly going to die within the week, then you are doing a disservice to the patient and any close families involved. You don't have to give him such false hope, but rather make him comfortable so that he can determine his final actions. Such false hope strips the patient of his right to self-determination.
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I agree 100%.
 
Geneticist said:
I agree 100%.
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What exactly are you trying to do then?

Because you are directly disagreeing with an example you stated claiming it would be your course of action?

😕
 
Geneticist said:
Just to play Devil's advocate a little...

Let's just say disease X has a 100% mortality rate. Patient A has disease X and isn't expected to live for more than a week. Would you be willing to tell Patient A that they are, without a doubt, going to die? Or would you instead try to instill hope and encourage them to survive by telling them that it is possible to survive despite medical evidence? I'd be willing to lie.
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Life has a 100% mortality rate. Also, I believe there was a study showing that doctors are relatively good at predicting people who are going to die in 24-48hrs, but after that it becomes fairly unreliable. But both are beside the point...sort of.

You've created a false dichotomy. You present Option A) You're going to die in a week (which you label truth) and Option B) You're going to live...(forever?)(which you label a lie). I can't really envision a scenario in which you would use either scenario.

But I'll use a real-world example that is as close as I can think of. Say you have a patient in the ICU who has been intubated for a month. Say you also have a paper stating that patients >age X who have been intubated for >2 weeks have a 100% mortality at 1 year (there is a paper similar to this that I'm not going to bother looking up right now). The conversation with the patient and/or family would probably go something like this, "unfortunately, studies have shown that patients in situations similar to Y's are all deceased within a year. Now, studies don't tell what WILL happen in the future, only what will LIKELY happen based on what has happened in the past. It is always best to hope for the best and expect the worst, and it is important that you understand what the worst is in this situation."

I understand where you're coming from, but I would argue that the overwhelming majority (if not all) of such scenarios would benefit from a careful and optimistic phrasing of the truth and not a lie. Lying in such situations is patronizing, counter-productive, and a discredit to yourself and your profession.
 
BDIX727 said:
Are you kidding? 100% mortality rates absolutely means death is certain.

You haven't taken Stats I suppose, but if somebody has a disease with a 100% death rate, they are certainly going to die.
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i have taken stats and i disagree with this. a 100% mortality rate means that everyone who has previously had the disease has died from it, but only speaks about the probability of future events, not the certainty. just because there is a 100% mortality rate doesn't necessarily mean you are going to die.

many diseases may have once had a 100% mortality rate, but eventually people defy the odds and the rate is no longer 100%. upon visible symptoms, rabies once had a 100% mortality rate and anyone who acquired the disease thought for sure they were going to die. years later, there have been several people who have survived, albeit few, and the rate is no longer 100.
 
Mbeas said:
i have taken stats and i disagree with this. a 100% mortality rate means that everyone who has previously had the disease has died from it, but only speaks about the probability of future events, not the certainty. just because there is a 100% mortality rate doesn't necessarily mean you are going to die.

many diseases may have once had a 100% mortality rate, but eventually people defy the odds and the rate is no longer 100%. upon visible symptoms, rabies once had a 100% mortality rate and anyone who acquired the disease though for sure they were going to die. Years later, there have been several people who have survived, albeit few, and the rate is no longer 100.
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Okay, if we want to play statistics...

Let's say this is a Rare Disease, only 1000 people have came down with it.

No known survivors, The Odds of you being the one who does survive?

Can you calculate it? It is 3:40am where I am at right now, if no answer... I'll finish it tomorrow morning.
 
WholeLottaGame7 said:
I understand where you're coming from, but I would argue that the overwhelming majority (if not all) of such scenarios would benefit from a careful and optimistic phrasing of the truth and not a lie. Lying in such situations is patronizing, counter-productive, and a discredit to yourself and your profession.
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I see what you mean now. I took this "optimistic phrasing" to be a form of lying but if done properly it isn't. I've seen many people in a non-medical setting to "optimistically phrase" something and having it turn out to be a complete lie. Obviously good doctors wouldn't make that kind of mistake though...

I gotcha now 😉
 
Geneticist said:
http://www.bbc.co.uk/ethics/lying/lying_1.shtml

There's a section nearer the bottom that talks about lying and its relation to medical ethics.
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Good article, worth reading. If you'll notice, all of the proposed scenarios have a counter-argument to them.

As noted, there are some scenarios whereby lying would be accepted, but most of them relate to the perpetrator of the lie being in extremis and avoiding personal harm. And while you may have patients in extremis, you as a doctor are never in extremis when dealing with a patient.
 
WholeLottaGame7 said:
I understand where you're coming from, but I would argue that the overwhelming majority (if not all) of such scenarios would benefit from a careful and optimistic phrasing of the truth and not a lie. Lying in such situations is patronizing, counter-productive, and a discredit to yourself and your profession.
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Well said 👍


... and I'd like to add, justifying lying to patients will likely blow your interview.
 
BDIX727 said:
Okay, if we want to play statistics...

Let's say this is a Rare Disease, only 1000 people have came down with it.

No known survivors, The Odds of you being the one who does survive?

Can you calculate it? It is 3:40am where I am at right now, if no answer... I'll finish it tomorrow morning.
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i didn't want to play statistics...

you are missing the point. i understand my odds of survival are very low. however, a high mortality rate does not include a guarantee of death. it only reflects the past, while speaking of the probability of the future. in your scenario above, i would probably die. but would i necessarily die? no.
 
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