REFLECT

Model stories written by young professionals/students.

Honesty is key

A student contemplates the history and significance of the Patient Bill of Rights.

While many policies that are implemented in the medical field today are the result of much evolution over the years, arguably the most important implementation into modern day medical culture is the policy that mandates a physician to inform the patient of their medical condition(s). This notion was not routine until the recent decades of medical practice-despite sounding like common sense to minds of the contemporary era. The “common sense” first reaction to this topic stems from years and years of rights organizations fighting for a fully transparent window into their medical records instead of a report the medical practitioner had the power to distort in any which way.

Prior to the year 1972, physicians were not required to tell patients about every medical condition they possessed, and most of the time, they did not. Lying to the patient was most common when there was the option to disclose information about a fatal or serious condition such as cancer. For example, as discussed in the book Strangers at the Bedside by David Rothman, “when the 1960s began, almost all physicians (90 percent in one study) reported that their “usual policy” was not to tell patients about a finding of cancer” (Rothman 147). This was not done as a hateful or inconsiderate act towards the patient, however. It was believed that, if the patient knew they were dying, it would harm them more than help them. This was not disputed by ethics experts, “many moral philosophers referred to physician discourse with patients as an exception to the obligation to tell the truth” (Drane). Therefore, purposely withholding information from the patient was seen not only as acceptable, but also as charitable—especially in a time where there was barely a fraction of the treatments that are around in the modern day.

The charitable feeling was not shared by the patients, though. Once the general public became interested in having a predominant role in their medical care, rampant criticism was generated from the increasing distrust between physician and patient. The patients’ concerns were not unwarranted. When the patient goes into the physician’s office ill, they expect to hear what is wrong and what should be done to treat it. If there was no way to treat it, the patient would expect to know what their condition is anyway so they could get their affairs in order. This way of thinking goes along with how “the patient…was interested in controlling his or her destiny” (Burnham 1478). If the patient was interested in being at the helm of their care and the physician lies to them, the patient would be able to tell that their health was still declining from how they feel, and this would create a large wall of mistrust between the physician and patient (Burnham 1476-1479).

The National Welfare Rights Organization drafted a list of twenty-six proposals for the Joint Commission on the Accreditation of Hospitals which was eventually adopted as the Patient Bill of Rights by the American Health Association. The document specifically addressed keeping the patients informed: “The patient has the right to receive…adequate information concerning the nature and extent of his medical problem, the planned course of treatment, and prognosis” (Rothman 146). Once identified as a patient’s right, physicians realized its importance and began to promote this practice (Rothman 145-147).

In the present day, patients are informed of everything that happens during their visit with the physician. Most times, the patient is even informed of minor and routine tasks such as to what the doctor is looking for when they shine a light in the patient’s ear or the purpose of listening to the patient breathe through a stethoscope. Nothing is a more drastic change from entering a physician’s office and being subjected to unknown tests with unknown purpose and then being presented with a false diagnosis. The Patient Bill of Rights mimics the Constitutional Bill of Rights and is treated with just as much importance within the medical profession; the Patient Bill of Rights is a vital example of how patients identified an immoral aspect of the medical profession and worked diplomatically to ensure such immorality was not part of their lives. Physicians often hold the lives of patients in their hands, and it is rational that the patients should know what is going on.

-KC Lynch

Work Cited

Burnham, J. "American Medicine's Golden Age: What Happened to It?" Science 215.4539 (1982): 1474-479. Web.

Drane, James F. "Honesty in Medicine: Should Doctors Tell the Truth?" University of Chile. N.p., n.d. Web. 27 Jan. 2016.

Rothman, David J. Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making. New York, NY: Basic, 1991. Web.