Vol 16, No 1 (2022)
Review paper
Published online: 2021-12-30

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In defence of telling the truth to patients with dementia

Jan Hartman1
Palliat Med Pract 2022;16(1):77-82.


In this bioethics’ paper, I oppose the arguments justifying lying and deceiving persons with dementia for
their good or out of compassion. The goals achieved by lying and deception should be achieved in other
ways. However, although in some extraordinary cases, a medical professional or caregiver can depart
from the veracity rule, this cannot lead to the invalidation of truth-telling, being a conditio sine qua non
of the respect for patient`s dignity. In addition, the consequentialist argument that says that a person
with dementia, while losing his or her discernment of the world, cannot be harmed when becoming the
addressee of a lie is wrong. I argue that accepting deception is not only paternalist and contradictory to
the principle of respect for patients but also harms the dignity of the caregiver community or care homes
institutions. If a dementia patient is not able to take care of his or her status as an adult and a person
worthy of respect, this task should be taken over all the more by caregivers. This is because dignity is
a social value, constituted in social interactions (shared dignity). Truthfulness is often a harder choice to
make, however, it should be given priority for the sake of human dignity, as well as for the authenticity
of the personal relations among those who provide care to the patient — at home or in a care home.
Avoiding the easier choice, which deception often is, requires an effort to build the communication skills
necessary to give bad news in the least harmful way possible.

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