Giving Patients False Hope

¶ … Medical Ethics According to Ruddick, not all forms of giving up hope are rooted in despair. Sometimes allowing a patient to give up hope can be a compassionate response, such as when a terminally-ill patient enters palliative care. There is a distinction between being 'bereft' of hope and simply being without hope. Hope-giving can be seen as a violation of the principle of autonomy and acknowledging the lack of hope can be an important step forward in patients being able to make rational decisions about their health (Ruddick 346).

Ruddick also criticizes self-deception, or the idea that the sufferer may delude him or herself into thinking his or her condition is better than it actually is in reality: allowing this does not seem congruent with the principle of autonomy, either. The McCartney story illustrates an example of when physicians withhold information which they consider 'life-shattering' and would severely inhibit the quality of the individual's limited lifespan.

Supposedly, Paul McCartney did not fully inform his wife of the extent of her illness so the couple could go on composing music together (Ruddick 348).

However, this rationale seems odd: is it not possible that, given the knowledge that she was dying, Linda McCartney would have wanted to compose music even more? Also, what if she did not want to compose music but instead wanted to do other things with her life, given her knowledge that her time on earth was finite? It seems arrogant to make such a decision for the victim of a serious illness, no matter how well-intentioned the concept.

Medical deception is seldom used with a nefarious purpose and is designed to encourage the sufferer to focus on possibilities rather than probabilities, according to Ruddick (Ruddick 349). However, when relatives collude with physicians who engage in false hope-giving, this can create an entire environment around the patient of deception, as the people who should have the patient's best interests at heart work to convince the patient of what is false, medically speaking, and avoid addressing the real issues affecting the patient (Ruddick 352).

Giving parents false hopes also lies within the problematic rationale of beneficence because of the harms generated when hopes are raised and then dashed. Also, when the patient and his or her family are already optimistic, there may be little need for engineered, false hope with all of its ethical problems. The principles of hope-giving must balance the competing dangers of deception and acknowledge that patients and their families have a more possibility-focused ethos of hope, versus physicians which are more probability-focused (i.e., driven by the numbers) (Ruddick 356).

A family member will almost invariably hold out hope for a cure, particularly when a child is concerned, versus a physician who has a more realistic assessment of the likelihood of success. There is no single answer about when to allow for excessive or deceptive hope and it is context-dependent. The physician weighs.