Beware the lies of patients

A decade ago I started my PhD. I took great pride in the simplicity of my research question, which was reducible to eight words: “Should doctors always tell the truth to patients?” The answer, after three years of hard labour, was “most of the time.” The other 99 000 words merely elaborated on that answer, but there was one digression that examined how patients deceive doctors.

This fascinating and understudied issue appears in the Hippocratic corpus in the 4th and 5th centuries BC. One passage advises readers to “keep a watch also on the faults of the patients, which often make them lie about the taking of things prescribed.”1

In the early 1990s Burgoon and colleagues reported that 85% of the patients they interviewed admitted concealing or equivocating about information to their doctors, and roughly a third claimed to have lied to their doctors.2

Patients deceive doctors for various reasons. With some patients, the deception forms …