In Defence of Causing Patients to Worry
Ethical Issues in the Communication of Diagnostic Uncertainty
Bibliographic Data
| ID | 21504331 |
|---|---|
| Authors | Caitríona Cox (0000-0001-9416-9509, Strangeways Research Laboratory, THIS Institute University of Cambridge Cambridge UK, corresponding author), Zoe Fritz (0000-0001-9403-409X, Strangeways Research Laboratory, THIS Institute University of Cambridge Cambridge UK) |
| Year | 2025 |
| Volume | 39 |
| Issue | 7 |
| Pages | 700-708 |
| Publication date | 2025-09-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Bioethics (JOURNAL) |
| Journal identifiers | ISSN: 0269-9702 • E-ISSN: 1467-8519 |
| Publisher | Wiley (PUBLISHER • GB) |
| DOI | 10.1111/bioe.13436 |
| PMID | 40500973 |
| OpenAlex | W4411223837 |
| Language | EN |
| References cited | 93 |
Doctors are often motivated by a desire to avoid causing their patients worry. In this paper, we provide a defence of disclosing diagnostic uncertainty information to patients, even if such disclosures are worrying. We first consider whether making a patient worry harms them, arguing that worry can be harmful in some—but not all—situations. Although worry is an aversive emotion, sometimes, worry can be beneficial (e.g., if the worry drives adaptive behaviours that are ultimately good for the patient's well‐being). In contrast, worry that is excessive, or is related to events outside the patient's control, can be considered harmful. Even if worry is harmful, communicating worrying information can still sometimes be justified—for example, by applying a consequentialist harm–benefit analysis to consider whether the other benefits of the disclosure (broadly defined) might outweigh the harm created by the worry. We do, however, note the difficulty in predicting how an individual patient will respond to the disclosure of potentially worrying information (as the preference for greater communication of diagnostic uncertainty may not be universal). We conclude that a holistic consideration of the expected consequences of communication—including self‐assessment by the doctor to avoid unwitting bias or unwarranted projection of their own values—often supports the communication of diagnostic uncertainty information, even if it worries the patient
Anxiety · Autonomy · Beneficence · Engineering ethics · Ethical issues · Political science · Psychiatry · Worry · Clinical Reasoning and Diagnostic Skills · Engineering · Law · Medicine · Mental Health and Psychiatry · Patient-Provider Communication in Healthcare · Psychology · Social Psychology
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Sociology of diagnosis
Harm, Failing to Benefit, and the Counterfactual Comparative Account
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The Harm Principle and the Nature of Harm
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The Metaphysics of Harm
Consequentialism and Cluelessness
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| Highly cited | No |
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