The principle of respect for autonomy requires informing patients adequately and appropriately about diagnoses, treatments, and prognoses. However, some clinical cases may cause ethical dilemmas regarding telling the truth. Under the existence especially of certain cultural, social, and religious circumstances, disclosing all the relevant information to all pertinent parties might create harmful effects. Even though the virtue of telling the truth is unquestionable, sometimes de facto conditions compel physicians to act paternalistically to protect the patient/patients from imminent dangers. This article, (...) which aims to study the issue of whether a physician should always tell the truth, analyzes an interesting case that represents the detection of misattributed paternity during pre-transplant tests for a kidney transplant from the son to the father in Turkey, where social, cultural, and religious factors have considerable impact on marital infidelity. After analyzing the concept of telling the truth and its relationship with paternalism and two major ethical theories, consequentialism and deontology, it is concluded that the value of the integrity of life and survival overrides the value of telling the truth. For this reason, in the case of a high possibility of severe and imminent threats, withholding some information is ethically justifiable. (shrink)

To date, existing studies on paltering argue the thesis that paltering is never ethically justifiable; it is akin to deception, since one uses truthful statements with an intention to deceive. This study contends the above essential description and rather argues the thesis: it is a hasty generalisation to conclude that just because paltering has been employed in some fields such as the fields of negotiation and politics to deceive, it is therefore synonymous with deception. Specifically, I show in this study (...) that paltering does not necessarily imply deception, and is distinct from lying. And following a particular interpretation of a moral theory from the global South – ubuntu – paltering is a justified (as well as ethically acceptable) non-disclosure strategy when truthful disclosure would harm one’s relational capacity or jeopardise social cohesion. I am optimistic that this study makes a conceptual contribution to ethical literature on paltering, and introduces fresh perspective to the same by showing how an African moral theory may be used to evaluate paltering. (shrink)

This paper discusses the Saudi Arabian case by Abdallah Adlan and Henk ten Have, published in a 2012 issue of the Journal of Bioethical Inquiry, regarding a congenitally disabled child enrolled in a research project examining the genetics of her condition. During the course of the study, her father was found not to be genetically related, and the case discussed the dilemma between disclosing to the family all findings as promised in consent documents or withholding paternity information because of the (...) likely severe social repercussions. Using Adlan and ten Have’s example, this paper proposes a framework to consider cases outside of the conventional bioethics frame of reference, splitting the bioethical task into three elements: understanding the problem from the patient’s and the clinician’s perspective and then engaging in dialogue to decide what to do next. The process of dialogue between affected parties is vital. Presuming that there is a common morality undermines the effectiveness of the dialogue needed to find a resolution. (shrink)