Reevaluating Benevolent Deception: A Trust-Oriented Approach to Ethical Mediation in Multicultural Healthcare

AbstractBenevolent deception-the practice of intentionally withholding or distorting information to protect patients from harm-raises significant ethical concerns, particularly in multicultural healthcare settings, where cultural norms may endorse deception as an act of care. Nancy Neveloff Dubler strongly opposes deception, arguing that it compromises the integrity of clinical ethics consultants (CECs), erodes trust, and distorts the role of ethical mediation. This article explores the ethical tensions surrounding benevolent deception, particularly in cases where families request that physicians deceive patients based on cultural expectations. Drawing from Dubler's vision of CECs as mediators rather than enforcers, I propose a trust-oriented approach that enables CECs to facilitate shared ethical deliberation, foster open dialogue, and respect cultural differences while upholding core bioethical principles. Ultimately, this approach reaffirms Dubler's legacy by advocating for clinical ethics consultation as a transparent, patient-centered process that prioritizes trust, integrity, and informed decision-making over deception.