In defence of telling the truth to patients with dementia

Abstract

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.