醫學二 李桎陞 B

 There is an open secret in medicine--- patients lie.  Hippocrates said that patients can't always be trusted when they say they've taken their medicine.  Can doctors trust their patient?

 Lying is giving some information while believing it to be untrue, intending to deceive by doing so.  A lie has three essential features:  A lie communicates some information  The liar intends to deceive or mislead  The liar believes that what they are 'saying' is not true

 WebMD invited readers to respond to an online survey. The nearly 1,500 responders told us whether, when, and why they don't tell their doctors the whole truth.  WebMD users say they are pretty good liars. Only 7% said their doctor had ever caught them in a lie.

38% lied about following their doctors' orders 32% lied about their diet or about how much exercise they got 22% lied about smoking 17% lied about sex 16% lied about how much or how often they drink alcohol 12% lied about recreational drug use 7% lied about getting a second opinion 7% lied about taking herbs, supplements, or alternative therapies 6% lied about their personal or family history 2% didn't tell their doctors about some of their symptoms -- or exaggerated their symptoms 1% lied about feeling better 1% lied about their pain 1% lied about abortions or earlier pregnancies 1% lied about mental health or depression 3% lied about other things

50% said they didn't want to be judged 50% said they didn't want to be judged 31% said the truth was just too embarrassing 31% said the truth was just too embarrassing 21% didn't think the doctor would understand 21% didn't think the doctor would understand 9% said it was none of their doctor's business 9% said it was none of their doctor's business 6% lied to get a particular drug or treatment 6% lied to get a particular drug or treatment 2% said they would not get medications 2% said they would not get medications 2% didn't want a lecture 2% didn't want a lecture 1% didn't think the lie was important 1% didn't think the lie was important 1% lied because they disagreed with their doctor 1% lied because they disagreed with their doctor 1% didn't want the truth to appear on the medical records or to be available to their insurance companies 1% didn't want the truth to appear on the medical records or to be available to their insurance companies 5% gave other reasons for lying 5% gave other reasons for lying

 feelings of guilt

 Within medicine, physicians are often tempted to retaliate （報復） against patients who lie by withholding treatment  Lies that go unrecognized can promote misinformation or lead to treatment that is inappropriate or harmful.

1) How can one detect lies? 2) How the physicians treated the lies of the patient?

 speech patterns and facial cues  voice pitch  use of indirect speech and pauses  Altered rate of speech  changes in breathing patterns, sweating, and an increase in swallowing

 rehearse different communication strategies  Disclosed the patient