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January 24, 1994

Truth Telling in Medicine

Author Affiliations

Baltimore, Md

Arch Intern Med. 1994;154(2):226. doi:10.1001/archinte.1994.00420020150017

In his article entitled "Offering Truth: One Ethical Approach to the Uninformed Cancer Patient,"1 Freedman describes a valuable pearl for internists, because it provides an additional technique for our most potent procedure, ie, talking with patients and their loved ones. "Truth is good, but not all truth is good to tell" goes the African proverb. To admit that some truth should be avoided—even denied—is a perilous position for an internist, but one that an honest clinician shall encounter in his career.

An oncologist once shared this pearl with me: "You must always tell the truth, but you must always tell it with hope and kindness. You can't have the one without the other two."

I submit that this construct of truth telling in medicine is like an equilateral triangle. Truth, hope, and kindness are evenly balanced with no one vertex in excess. However, we internists must accept the occasional

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