Balancing honesty and benevolence in dementia care: A commentary on therapeutic lies and codes of ethics.

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.

BACKGROUND

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.

EVALUATION

Nursing codes are reviewed in conjunction with empirical research on prosocial and therapeutic lies and how nurses interpret and implement codes.

KEY ISSUES

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.

CONCLUSION

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.

IMPLICATIONS FOR NURSING MANAGEMENT

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.