Truthfulness is the foundation of the doctor-patient relationship, both as a method of discourse and as one of the "most widely praised character traits" of a doctor. Gone are the days when doctors withheld certain diagnoses or treatment details from patients. If anything, doctors today are often forced to disclose excess and sometimes unnecessary information due to concerns about liability or to patients who have already canvassed the Internet on their own and have pressing questions. The doctor's challenge is to present what he or she knows to be true about the diagnosis and its treatment options and to do so in a manner that truly informs the patient. But there are limitations and pitfalls to this process, as illustrated in the following paraphrased conversation I recently had with a seventy-five-year-old moderately demented patient and his wife:Marc E. Agronin, The Atlantic, october 24, 2011.
Patient: Doctor, I know I can still drive. Just let me take a test.
Doctor A: I'm sorry, Mr. K, but I can't help you with that. As we discussed, your memory impairment makes it unsafe for you to drive.
Patient: Just let me take the test. I can drive just fine.
Doctor A: The memory testing tells us that you would not be a safe driver.
Patient: My memory is not that bad. I know I can drive.
Patient's wife: Honey, I told you that the car is not working now and needs to be fixed. Let's talk about it later.