An airline pilot goes for his regular medical check up. The doctor discovers that he has developed a heart murmur.  The pilot has only one month to go before he is eligible for retirement. The doctor knows this, and wonders whether, under these unusual circumstances, she is justified in withholding the information about the pilot’s condition. Is the doctor justified in withholding this information? Why or why not? 2 page response; use citations and APA style


The ethical dilemma presented in this scenario revolves around the question of whether a doctor is justified in withholding information about a patient’s medical condition, specifically a heart murmur, when the patient is nearing retirement and has only one month left before becoming eligible for retirement. This paper will analyze the ethical considerations involved in this situation and present arguments both for and against withholding the information, citing relevant literature from the field.

Ethical Principles in Healthcare

In medical ethics, four fundamental principles guide decision-making: autonomy, beneficence, non-maleficence, and justice. Autonomy refers to respecting the patient’s right to participate in medical decisions and be informed about their condition. Beneficence concerns the duty of healthcare professionals to act in the patient’s best interest, while non-maleficence highlights the obligation to avoid harming the patient. Justice is focused on distributing healthcare fairly and equitably (Beauchamp & Childress, 2019).

Patient Autonomy and Informed Consent

Respecting patient autonomy is a central principle in medical practice. Patients have the right to be fully informed about their health conditions and to participate in decision-making regarding their treatment. Informed consent is a crucial component of patient autonomy, meaning that patients must be provided with all relevant information to make informed choices about their healthcare (Beauchamp & Childress, 2019).

Withholding information from a patient, even with the intention of protecting them from emotional distress, violates the principle of autonomy. In this case, the pilot has a right to know about his heart murmur to make decisions regarding his retirement plans, as well as any necessary modifications in his lifestyle or work routine. By withholding the information, the doctor would be undermining the pilot’s autonomy and denying him the opportunity to consider all the relevant factors in his retirement decision.

Beneficence and Non-Maleficence

Beneficence and non-maleficence urge healthcare professionals to act in the patient’s best interest and avoid harm. While these principles may appear to support withholding information to protect the pilot from emotional distress, it is important to consider the long-term consequences and wellbeing of the patient. By receiving accurate and complete information, the pilot can seek appropriate medical care and lifestyle adjustments to manage his condition and possibly prolong his overall health and longevity.

Hiding the diagnosis from the pilot could lead to potential harm if the condition deteriorated during the remaining month of service. This could result in a sudden medical emergency that endangers the safety of passengers and crew. From a non-maleficence perspective, an accurate diagnosis would allow the pilot to take necessary precautions and consult specialists who can provide appropriate guidance to mitigate the risks associated with his condition.

The principle of beneficence also emphasizes the duty of healthcare professionals to promote the overall wellbeing of the patient. By informing the pilot of his heart murmur, the doctor is acting in his best interest, acknowledging the value of open and honest communication in maintaining trust between healthcare providers and patients.

Justice and Equity in Healthcare

The principle of justice requires healthcare professionals to distribute healthcare resources fairly and equitably. While it may be arguable that withholding information could serve the collective interest by preventing potential disruptions in the airline schedules or avoiding negative consequences on other pilots, this approach disregards the individual pilot’s right to equitable access to healthcare. Every individual deserves equal consideration and respect regarding their health, regardless of their proximity to retirement or their occupation.


In conclusion, the doctor is not justified in withholding information about the pilot’s heart murmur. The principles of autonomy, beneficence, non-maleficence, and justice in healthcare ethics suggest that patients have a right to be fully informed about their medical conditions and to participate in medical decision-making. While there may be short-term considerations for withholding the information, potential harm to the pilot’s health and the breach of ethical principles outweigh these concerns. Open and honest communication is vital in maintaining patient trust and ensuring the pilot’s long-term health and overall wellbeing.