White Lies and Pragmatic Ethics in Nursing: A Narrative Review of the Tension between Truth and Compassion
akhlāq-i pizishkī i.e., Medical Ethics,
Vol. 19 (1404),
25 September 2025
,
Page 1-18
https://doi.org/10.22037/mej.v19i-.49496
Abstract
Background and Aim: Nurses frequently face complex ethical dilemmas in the process of caring for clients in order to create a balance between the ethical principles of truth-telling and compassion. Given the lack of studies in this field, this study aimed to explain expedient lies and pragmatic ethics in nursing.
Method: This study was conducted as a narrative review from April to July 2025. Searches were conducted in PubMed, CINAHL, Scopus, Web of Science, Magiran, SID databases using keywords such as "white lies in nursing", "therapeutic deception", "ethics of compassion", "truth-telling in healthcare", "pragmatic ethics" and "beneficence vs. autonomy" and their Persian equivalents, individually or in combination with each other, without time limit. After retrieving articles and screening them based on inclusion and exclusion criteria, data analysis was performed based on the Narrative Synthesis method.
Ethical Considerations: Ethics are a fundamental principle in any research. The present study was approved by the university ethics committee.
Findings: Data analysis showed that there is a persistent and meaningful ethical tension between the principle of truthfulness and the principle of compassion in nurses' clinical practice. Nurses use expedient lies as a practical strategy when dealing with vulnerable patients to prevent psychological distress in patients; maintain hope in the treatment process; and strengthen the therapeutic bond. The data showed that the lack of standardized ethical guidance frameworks can lead to ethical doubts among nurses; overreliance on personal judgments, and inconsistency in clinical decision-making.
Conclusion: The use of pragmatism in nursing ethics, although beneficial in resolving clinical conflicts, is associated with the risk of moral relativism and a misunderstanding of professional flexibility. It is suggested that regulatory bodies create a balance between pragmatism and basic ethical principles by developing situation-based clinical guidelines.
- Nursing Ethics
- Truth-Telling
- Compassion
- White Lie
- Pragmatic Ethics
- Pragmatism
How to Cite
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