Metro South Health, Brisbane, Queensland, Australia.
J Nurs Manag. 2022 Oct;30(7):2241-2244. doi: 10.1111/jonm.13659. Epub 2022 May 23.
AIM(S): This commentary suggests that within the context of dementia care, the revision of nursing codes of ethics to accommodate the acceptability of therapeutic lies under limited circumstances may be appropriate.
Therapeutic lies (a prosocial lie) are told in the best interests of a person with dementia, to avoid distress or harm that may be derived from an act of truth-telling. However, their acceptability remains a contentious issue and is not reflected in nursing codes.
Nursing codes are reviewed in conjunction with empirical research on prosocial and therapeutic lies and how nurses interpret and implement codes.
Prosocial lies are perceived to be ethically preferable when truth-telling causes unnecessary harm. However, nurses may feel conflicted using therapeutic lies believing honesty to be obligatory.
Codes may benefit from revision, by acknowledging the permissibility of therapeutic lies under limited circumstances. This may assist nurses with ethical decision-making and potentially reduce distress in this challenging area of practice.
It may be beneficial for nurse mangers to initiate discussions with staff regarding unnecessary harm and therapeutic lies. Nurse managers may also wish to advocate for the revision of codes as suggested in the commentary.
本评论认为，在痴呆症护理的背景下，修订护理道德规范以在有限的情况下接受治疗性谎言可能是合适的。
治疗性谎言（一种亲社会的谎言）是为了痴呆症患者的最佳利益而说的，以避免因说实话而可能带来的痛苦或伤害。然而，它们的可接受性仍然是一个有争议的问题，并没有反映在护理规范中。
护理规范与亲社会和治疗性谎言的实证研究以及护士如何解释和执行规范一起进行了审查。
当说实话会造成不必要的伤害时，亲社会的谎言被认为在道德上更可取。然而，护士在使用治疗性谎言时可能会感到矛盾，因为他们认为诚实是强制性的。
规范可能会受益于修订，承认在有限的情况下允许治疗性谎言。这可能有助于护士做出伦理决策，并有可能减少在这一具有挑战性的实践领域中的痛苦。
护士长与员工就不必要的伤害和治疗性谎言进行讨论可能是有益的。护士长也可能希望倡导像评论中所建议的那样修订规范。
