This Question is an extension of a Question posed earlier titled
“Is there anything that I shouldn’t tell my doctor about my life and is there anything about which the doctor shouldn’t ask?” (http://www.medpedia.com/questions/1099-is-there-anything-that-i-shouldnt-tell-my-doctor-about-my-life-and-is-there-anything-about-which-the-doctor-shouldnt-ask )


In these days of patient autonomy, the question is how far should the autonomy be extended? Should the patient exercise an option to go beyond simply “withholding” but actually lie (to deny or distort or create the history or symptoms) to their doctor? When a patient goes to a physician for a diagnosis and treatment I suspect that it is assumed, certainly by the physician, that the patient will reveal a personal history truthfully. But if the patient lies to the doctor, do you think that the patient can defend that action ethically or even in the practical terms despite the potential for a missed diagnosis or literal harm to the patient, perhaps during treatment. Are there any excuses that a patient could give for lying? What rational excuse could a patient give for this behavior? What does a patient have to gain by lying? Would it be an attempt to gain a drug prescription which the patient might not receive otherwise? Would it be to assure that the doctor would have greater concern or pay greater attention to the patient or to appear “better” in the eyes of the doctor? How should a physician react and respond to a patient when gross lying is discovered? Should lying by the patient be a basis for the physician to dismiss the patient?

I await an initial response from the Medpedia readers but I may later contribute some additional questions and thoughts. ..Maurice.