Should doctors ever lie to benefit their patients—to speed recovery or to conceal the approach of death? In medicine as in law, government, and other lines of work, the requirements of honesty often seem dwarfed by greater needs: the need to shelter from brutal news or to uphold a promise of secrecy.
    What should doctors say, for example, to a 46-year-old man coming in for a routine physical checkup who, though he feels in perfect health, is found to have a form of cancer? If he asks, should the doctor deny that he is ill, or minimize the gravity of the illness? Doctors confront such choices often and urgently. At times, they see important reasons to lie for the patient's own sake. In their eyes, such lies differ sharply from self-serving ones.
    Studies show that most doctors sincerely believe that the seriously ill do not want to know the truth about their condition, and that informing them risks destroying their hope, so that they may recover more slowly, or deteriorate faster, perhaps even commit suicide. As one physician wrote: "Ours is a profession which traditionally has been guided by a precept that transcends the virtue of uttering the truth for truth's sake, and that is, as far as possible 'do no harm'." Armed with such a precept, a number of doctors may slip into deceptive practices that they assume will "do no harm" and may well help their patients.
    But the illusory nature of the benefits such deception is meant to produce is now coming to be documented. Studies show that, contrary to the belief of many physicians, an overwhelming majority of patients do want to be told the truth, even about grave illness, and feel betrayed when they learn that they have been misled. We are also learning that truthful information, humanely conveyed, helps patients cope with illness.
    Not only do lies not provide the "help" hoped for by advocates of benevolent deception, they invade the autonomy of patients and render them unable to make informed choices concerning their own health.
    Lies also do harms to those who tell them: harm to their integrity and, in the long run, to their credibility. Lies hurt their colleagues as well. The suspicion of deceit undercuts the work of the many doctors who are scrupulously honest with their patients; it contributes to the spiral of lawsuits and of "defensive medicine", and thus it injures, in turn, the entire medical profession.  Doctors think that lying to their patients is ______.