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January 24, 1994

Truth Telling in Medicine-Reply

Author Affiliations

Montreal, Quebec

Arch Intern Med. 1994;154(2):226. doi:10.1001/archinte.1994.00420020150018

I appreciate Karlawish's comments. In speaking with patients, as in any other medical intervention, it is necessary to distinguish between the substance and the manner of the intervention. Given that a venipuncture is needed, how will it be done? Students performing their first can be observed to fall prey to equal and opposite errors: the timorous, tentative probe, or the bold, overconfident jab. Both commonly miss their mark and need to be repeated; neither approach does the patient a favor. Once the need for truth-telling is established—as explained in my article,1 a medical intervention that should be within the patient's control—the art of medicine will lie in learning how to perform this task in a humane and effective manner.

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