Conflicts and Challenges of Truth-Telling in Dentistry: A Case-Based Ethical Analysis

Objectives: The basis of truth-telling is respecting the autonomy of patients and developing an ability to make informed decisions with valid consent. The purpose of this study was to ethically analyze the conflicts about truth-telling in dentistry. Materials and Methods: This case analysis focused on the issues of truth-telling in medicine and dentistry. The challenges encountered by dentists with respect to ethical issues related to truth-telling were discussed and analyzed by the research team. Results: The literature review showed that the issue of truth-telling in dentistry has been addressed from three aspects: Truth-telling about other dentists’ medical errors, truth-telling about dangerous, refractory, or incurable diseases, and truth-telling to children or incompetent individuals for decision-making. Conclusion: When the duty of the dentist in truth-telling is conflicted with some other moral obligations, the conflict between the prima facie duties arises. The principle-based ethical theories provide a suitable conceptual framework for moral judgement in such conflicts. In cases of conflicts related to truth-telling, a balance should be maintained between principles and rules such as fidelity, respect for autonomy, maintaining trust in dentist-patient relation, and best interest of patients. The decision in truth-telling should be made individually for each patient based on the specific contextual conditions.

Indigenous peoples’ human rights, self-determination and local governance – Part 2

Part 1 of this article explored the relevance of the United Nations Declaration on the Rights of Indigenous Peoples to the Aboriginal and Torres Strait Islander peoples of Australia, particularly the key principles of self-determination and free, prior and informed consent; how the international human rights framework applies in Australia; and Australia’s lack of compliance with it. Part One concluded by discussing the Uluru Statement from the Heart, presented to all the people of Australia in 2017, and how it marked a turning point in the struggle for recognition by Australia’s Indigenous peoples. Part 2 explores recent developments since the release of the Uluru Statement, especially at sub-national levels, in relation to treaty and truth-telling. It draws some comparisons with Canada and New Zealand, discusses the concept of coexistence, and presents a set of Foundational Principles for Parity and Coexistence between two culturally distinct systems of land ownership, use and tenure.

Truth Disclosure at the End of Life: A Qualitative Study of Internal Medicine Residents in the United Arab Emirates

Background Respect for patient autonomy has become the guiding biomedical ethical tenet in the West; yet, moral values are contextual and culturally relevant. In the collectivist society of the Middle East, families and physicians have historically believed that concealing truth about a terminal illness is more ethical and compassionate. Recent studies reveal a trend toward truth disclosure. Objective To gain insight into resident experiences with, and barriers to, truth disclosure in terminally ill patients in the United Arab Emirates (UAE). Methods Focus group interviews were conducted with first through fourth year internal medicine residents and recent graduates at two large academic medical centers in the UAE. Qualitative thematic content analysis was used to identify themes related to communication and truth telling in end-of-life care. Results Residents revealed that non-disclosure of medical information in serious illness is a common practice in UAE hospitals. Barriers to truth telling include family objection, deficits in medical training, and inconsistently implemented institutional guidelines. Conclusion Educational and policy interventions are needed to improve physician-patient communication, decrease patient-family-physician tension, and alleviate trainee moral distress.

Truth-telling and patients' diagnoses in optometric practice in Nigeria

Background: The doctor-patient relationship is crucial to health care services including eye care. Telling the truth is an important aspect of this relationship in ensuring safe and effective treatment and management of patients.Method: A qualitative study using one - on- one in- depth interviews (IDIs) and focus group discussions (FGDs). Forty four respondents comprising 10 eye care practitioners (ECPs) and 34 patients were recruited. The ECPs were between 32 to 51 years while the patients were between 18 and 50 years old.Results: Common lies told were mainly about age, onset or duration of condition, medications used prior to their visit to the doctor's and level of compliance to doctor's prescription. Others were about health status, history of self-medication and social habits like smoking and/or drinking. Reasons for telling some of these lies included fear of early retirement, fear of being judged or stigmatized, lack of privacy during clerking and embarrassment from being caught in a previous lie.Conclusion: Untruths and manipulation of information can damage the relationship between doctor and patient because it leads to distrust and this can compromise eye care. Keywords: Truth, doctor- patient, relationship, diagnoses

Data-driven news work culture: Reconciling tensions in epistemic values and practices of news journalism

This study investigates the epistemological implications of the appropriation of audience analytics in a data-driven news culture. Focussing on two central aspects of epistemology, epistemic value and epistemic practices, we ask two overall questions (1) How are audience metrics balanced and reconciled in relation to other standards in the justification of news as valuable knowledge? How are different practices of research and presentation, truth-seeking and truth-telling, prioritized in a news organization marked as a data-driven news work culture? The study presents a case study of a Scandinavian legacy news publisher that has pursued the embracing of a data-driven news work culture. It is based on a qualitative multi-method approach. The findings show how metrics are used as a superior standard in deciding on the epistemic value of news. This is expressed in strategies, guidelines and discussions in the newsroom, and put into practice in coaching, evaluations and rewarding of the performance of individual journalists. In the everyday news production, metrics are reconciled in relation to independent standards in journalism, related to the claims of news journalism to provide relevant and verified public knowledge about current events. Moreover, the study shows how the embracement of metrics radicalizes the focus on presentation, packaging and timing in the optimization of news material and in the valuing of professional practices. Efforts in research and truth seeking are more seldom explicitly valued. The work of fulfilling reasonable truth claims is mainly taken for granted.

In the Beginning was the Commons: Transformative Learning as Praxis for Regenerating the Cultural Commons

Culture is the medium through which human capabilities are transmitted. In this respect, culture may be understood as a commons that is consequential to the future of other forms of commons. Regenerating the commons is inherently and intrinsically associated with democratizing and partnering. The commons of shared meanings that enable truth telling are exploitable by the market when education is dominated by the market. If educational institutions are at the behest of the market and the state, education can neither be a commons nor be in the service of the commons. We can frame this circumstance as an enclosure of learning. Transformative learning facilitates a shifting from the mindset of exploiting the commons to a mindset of regenerating the commons. In fact, the core transformation that occurs in transformative learning is the liberation of awareness from identity enclosure. Such a liberation prepares the ground for growing partnership capabilities from the intimate to the global, essential for preserving and regenerating the commons. An education that transforms seeks to re-sacralize and regenerate culture as a commons, which can then enable partnership-based care towards all other forms of commons.