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Dr Verheecke's interesting comments were directed toward a case that I did not discuss—that of the incompetent patient. I can, however, essentially agree with his observations on this matter.I cannot, however, agree with the last statement in his letter, that "the real issue... is to tell the truth according to the patient's state of mind at the moment...." I think that one has an initial obligation to be as deliberately truthful as possible. Also, the basis on which one makes a judgment pertaining to the patient's "state of mind" would have to be examined carefully. This, at least, would be necessary to make me comfortable with this notion.Finally, in response to Dr Verheecke's concern about physicians who must practice in parts of the world where people suffer from an inability to talk openly about cancer, I think that physicians have the difficult and often painful obligation
Sheldon M. Truth Telling in Medicine-Reply. JAMA. 1982;248(2):169. doi:10.1001/jama.1982.03330020015007