Da Silva Carlos Henrique Martins, Cunha Renato Luiz Guerino, Tonaco Ronaldo Borges, Cunha Thulio Marquez, Diniz Ana Carolina Boaventura, Domingos Gustavo Gontijo, Silva Juliana Diniz, Santos Marcelo Vitral Vitorino, Antoun Melissa Ganam, de Paula Rodrigo Lobato
Avenida Rondon Pacheco, 3333 - Apartamento 103, CEP: 38400-050, Uberlandia-MG, Brazil.
Bioethics. 2003 Oct;17(5-6):417-24. doi: 10.1111/1467-8519.00357.
The presence of truth and honesty is a permanent demand, and becomes vital the more committed and intimate a relationship is. Medical practice is relevant to this discussion when one questions whether or not a physician should always tell their patient the truth in the face of a progressive or potentially fatal disease, regarding their diagnosis, outcome, therapy and evolution of the specific disease. From this discussion we aim, with the present report, to look at the truth applicable to the patient-physician relationship, and its ethical and moral implications; and also to look at where the Brazilian Code of Medical Ethics (BCME) and the medical literature stand regarding this issue. One concludes that there are only two moments not to tell a patient the truth: when the patient does not want to be informed, and when the truth could be iatrogenic. The question now is, when would the truth be iatrogenic? Physicians, in our opinion, would not be able to judge solitarily when the truth might be deleterious to their patient. Alternatively, we proposed the appointment of a multidisciplinary commission to help the doctor with such a decision.
真实和诚实的存在是一种永恒的要求，并且在关系越亲密、投入度越高时就越重要。当人们质疑面对进展性或潜在致命性疾病时，医生是否应该始终告知患者关于其诊断、预后、治疗及特定疾病发展情况的真相时，医疗实践就与这一讨论相关了。在本次报告中，我们旨在探讨适用于医患关系的真相及其伦理和道德含义；同时也审视巴西医学伦理法典（BCME）和医学文献在这个问题上的立场。人们得出结论，只有两种情况不向患者告知真相：患者不想了解时，以及真相可能导致医源性伤害时。现在的问题是，真相何时会导致医源性伤害呢？在我们看来，医生无法单独判断真相何时可能对患者有害。因此，我们提议设立一个多学科委员会来协助医生做出这样的决定。
