When are primary care physicians untruthful with patients? A qualitative study

Area of Science:

• Medical Ethics
• Qualitative Research
• Physician Communication

Background:

• Physician truthfulness is theoretically vital but empirically shows gaps with actual behavior.
• Prior research on physician deception focused on specialty care, not primary care.
• This study investigates truthfulness in primary care settings.

Purpose of the Study:

• To explore primary care physicians' experiences with truthfulness.
• To identify factors influencing physicians' honest communication with patients.
• To understand physicians' rationales for both truthful and untruthful communication.

Main Methods:

• Qualitative study involving focus groups and interviews.
• 32 primary care physicians from internal medicine, family practice, and pediatrics.
• Data collected in Boston, MA, and Baltimore, MD, metro areas (Dec 2014-Mar 2015).

Main Results:

• Outright lying was rare, but information slanting and withholding were common.
• Factors influencing truthfulness included patient education and societal pressures (e.g., avoiding unnecessary tests).
• Physicians viewed truthfulness as an ethical requirement, justifying deviations to promote well-being or avoid harm.

Conclusions:

• Training in "everyday ethics" is needed for challenges like patient requests for inappropriate tests or medications.
• Physicians perceive conflicts between the duty of truthfulness and other moral obligations.
• Further ethical analysis is required to guide physicians in balancing conflicting medical ethics principles.