Ethical Challenges in Short-Term Global Health Training
CASE 8: Telling the "Truth"

In this case, Jeffrey has learned just how complex the "truth" can be.

  • In the first vignette, he learned that different cultures and communities communicate the "truth" differently. Not all apparent conflicts about "truth telling" turn out to be real conflicts.

  • In the second vignette, he learned something closely related: In short-term programs abroad, trainees should recognize that who tells the truth can be just as critical as what is contained in the message. Locals and others who know a community well are more likely to know how the truth is communicated; they are also more likely to be trusted by those in the community.

  • In the final vignette, Jeffrey realized, quite to his surprise, that the themes about truth telling do not just arise with respect to "clinical" diagnoses. How a community understands the truth can affect other parts of short-term programming as well (such as health related educational interventions, as in this case).

Of course, in some instances, a trainee may find him or herself in a situation where the "truth" really is in conflict. Such situations were not examined in this case. Although ensuring these conflicts are real (as noted in vignette one) is a first step, we encourage trainees to work closely with their advisors, sending and host institutions, and sponsors to deal with these difficult situations. They admit of no simple solution.
Nonetheless, trainees, sending and host institutions, and sponsors can help ensure a successful and productive short-term training program by being alert to the complexity of "truth telling."

Additional Resources


© Stanford University Center for Global Health and the Johns Hopkins University Berman Institute of Bioethics.

Project funding provided by Doris Duke Charitable Foundation (DDCF)