Khorshidian Azam, Parsapoor Alireza, Shamsi Gooshki Ehsan
Department of Medical Ethics, School of Medicine, Tehran, University of Medical Sciences, Tehran, Iran.
Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Front Dent. 2022 Jan 4;19:1. doi: 10.18502/fid.v19i1.8342. eCollection 2022.
The basis of truth-telling is respecting the autonomy of patients and developing an ability to make informed decisions with valid consent. The purpose of this study was to ethically analyze the conflicts about truth-telling in dentistry. This case analysis focused on the issues of truth-telling in medicine and dentistry. The challenges encountered by dentists with respect to ethical issues related to truth-telling were discussed and analyzed by the research team. The literature review showed that the issue of truth-telling in dentistry has been addressed from three aspects: Truth-telling about other dentists' medical errors, truth-telling about dangerous, refractory, or incurable diseases, and truth-telling to children or incompetent individuals for decision-making. When the duty of the dentist in truth-telling is conflicted with some other moral obligations, the conflict between the prima facie duties arises. The principle-based ethical theories provide a suitable conceptual framework for moral judgement in such conflicts. In cases of conflicts related to truth-telling, a balance should be maintained between principles and rules such as fidelity, respect for autonomy, maintaining trust in dentist-patient relation, and best interest of patients. The decision in truth-telling should be made individually for each patient based on the specific contextual conditions.
告知真相的基础是尊重患者的自主权，并培养其在有效同意的情况下做出明智决策的能力。本研究的目的是从伦理角度分析牙科领域中关于告知真相的冲突。 本案例分析聚焦于医学和牙科领域中告知真相的问题。研究团队讨论并分析了牙医在与告知真相相关的伦理问题上所面临的挑战。 文献综述表明，牙科领域中告知真相的问题已从三个方面得到探讨：告知其他牙医的医疗失误、告知危险、难治或不治之症，以及向儿童或无行为能力的人告知以帮助其做出决策。 当牙医告知真相的职责与其他一些道德义务发生冲突时，就会出现显见义务之间的冲突。基于原则的伦理理论为这类冲突中的道德判断提供了合适的概念框架。在与告知真相相关的冲突案例中，应在诸如忠诚、尊重自主权、维持医患关系中的信任以及患者的最大利益等原则和规则之间保持平衡。关于告知真相的决策应根据每个患者的具体情况单独做出。
