title: Discovering the truth beyond the truth.
abstract: The question "What is truth?" is one of the oldest questions in philosophy. Truth within the field of medicine has gained relevance because of its fundamental relationship to the principle of patient autonomy. To fully participate in their medical care, patients must be told the truth-even in the most difficult of situations. Palliative care emphasizes patient autonomy and a patient-centered approach, and it is precisely among patients with chronic, life-threatening, or terminal illnesses that truth plays a particularly crucial role. For these patients, finding out the truth about their disease forces them to confront existential fears. As physicians, we must understand that truth, similar to the complexity of pain, is multidimensional. In this article, we discuss the truth from three linguistic perspectives: the Latin veritas, the Greek aletheia, and the Hebrew emeth. Veritas conveys an understanding of truth focused on facts and reality. Aletheia reveals truth as a process, and emeth shows that truth is experienced in truthful encounters with others. In everyday clinical practice, truth is typically equated with the facts. However, this limited understanding of the truth does not account for the uniqueness of each patient. Although two patients may receive the same diagnosis (or facts), each will be affected by this truth in a very individual way. To help patients apprehend the truth, physicians are called to engage in a delicate back-and-forth of multiple difficult conversations in which each patient is accepted as a unique individual.
authors.affiliation: Department of Palliative Care, Comprehensive Cancer Center, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Gerhild
authors.initials: G
authors.lastname: Becker
authors.affiliation: Department of Palliative Care, Comprehensive Cancer Center, University Medical Center Freiburg, Freiburg, Germany. Electronic address: karin.jors@uniklinik-freiburg.de.
authors.forename: Karin
authors.initials: K
authors.lastname: Jors
authors.affiliation: Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Block
mesh_terms: D003142:Communication; D006801:Humans; D008037:Linguistics; D010166:Palliative Care / Q000941:ethics*; D026684:Personal Autonomy; D010817:Physician-Patient Relations / Q000941:ethics*; D014342:Truth Disclosure / Q000941:ethics*
keywords: Truth disclosure; personal autonomy; physician-patient relations