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Duty and honesty

Duty and honesty

The issue of duty is important when considering ethical situations;18,36,62,63 most clinicians see themselves as obligated exclusively to the patient, and perceive that they have a fiduciary duty to their patient alone. In this context, an ethical choice may be interpreted as acceding to the patientโ€™s request.

A physicianโ€™s duty, however, is not only to the patient; it is also to the profession, the healthcare system at large, and to the insurer with whom the clinician has a contractual relationship. From a principlist approach, this also touches on the principle of justice. Others have suggested that truth-telling itself is a principle, rather than a virtue.64 Dermatologic surgeons should never take any steps that could erode patientsโ€™ trust in physicians overall, as our standingโ€”and thus our ability to have patients share openly and honestlyโ€”is based on perceived honesty and integrity.65โ€“71