Deception, Catholicism, and Hope: Understanding Problems in the Communication of Unfavorable Prognoses in Traditionally-Catholic Countries

Abstract

The doctor's use of deception in appropriate circumstances has commonly been considered a necessity of the medical art. Resistance to full and frank communication is typical of many traditionally Catholic countries, and particularly of Italy, a western country where Catholicism remains particularly influential. The Catholic teaching on truth and lies, and the problem of telling the truth to a severely ill patient is discussed. It is suggested that the contemporary Catholic model of gradually telling a terminal patient the truth, which looks reasonable and feasible in theory, is rarely followed in practice, as in the majority of cases the truth is not told tout court. Problems stem from the way in which medicine is currently practiced in Italy; from the synergism between Catholicism and the medical tradition's grounded paternalism; and from the ambiguity of the term 'hope'. Catholic ethics in fact recommends that the truth must be told without destroying hope, but the Catholic meaning of 'hope' is very different from its meaning in current language.

Moral Distress at the End of a Life: When Family and Clinicians Do Not Agree on Implantable Cardioverter-Defibrillator Deactivation

“…This distinction between letting life go and taking life is not uncommon in cultures that place strong emphasis on the value of human life or the preservation of hope. 2,4,12 In this case, the shock function of the ICD did, indeed, serve the intention of the surrogate decision makers to prolong life, meeting what they saw as their religious obligationsduntil the patient suffered a type of arrest that could not be treated by an ICD shock, or until the ICD battery was exhausted. The family did not view ICD generator replacement in the same way.…”

To tell or not to tell: attitudes of Chinese oncology nurses towards truth telling of cancer diagnosis

“…Some previous studies discussed hope and deception. (Ruddick 1999, Toscani & Farsides 2006). It seemed that deception in appropriate circumstances was commonly considered a necessity of the medical art.…”

Care staff’s self-efficacy regarding end-of-life communication in the long-term care setting: Results of the PACE cross-sectional study in six European countries

“…Previous studies found, for instance, that discussions of end-of-life topics by general practitioners occur most often in the Netherlands and least often in Italy (Evans et al, 2014), which could indicate how common it is for healthcare providers discuss end-of-life matters with patients. Furthermore, in Mediterranean countries such as Italy healthcare providers often practice partial-or non-disclosure of end-of-life issues, due to wishes of family who are often involved in care (Gysels et al, 2012) and to the importance of maintaining patient's hope and not causing them distress (Toscani and Farsides, 2006).…”