Wartime Lies

A good title should be short and catchy – so if this one looks familiar and works, you will already be wondering what this Editorial is all about. “Wartime Lies”[1] is the title of the first novel written by Ludwik Begleiter, better known as Louis Begley, at the age of 58 years. It became an instant success and turned its author's career from lawyer to writer.

Are we, like Maciek, the protagonist in the novel, currently in a war situation which may legitimate lies or at least not telling the whole truth? Many, yours truly included, find the terminology frequently used to describe the “battling” of the Covid-19 pandemic questionable, yet it abounds. A recent hospital newsletter states that we are “fighting an invisible and relentless enemy”, and then, after evoking parallels to Churchill's famous “darkest hour” speech in 1940, the staff is asked “not to give in in their resolute fight against the virus”. Are such questionable personifications and rallying battle cries appropriate for academics? What is next? “Total war?”

The problem is that these analogies are seemingly apt, personally touching, and blatantly obvious – and therefore part of the populist armamentarium. Should the medical community not be able to do better by refraining from unduly emotional appeals?

So much for the “wartime”. What about the “lies”? If one accepts the moralistic definition that not telling the whole truth is already considered a lie, untruthfulness becomes ubiquitous – not only during wartimes but then even more.

Is it, hence, justified to propagate a certain therapy by claiming lower patient exposure to the potentially dangerous (because Covid-infested) healthcare system only because patients will stay in a hospital just for a day or two? Does an extension of indications into a low-risk population, which technically rather has a recommendation for an alternative if more invasive and time-consuming therapy, really have a positive impact on the afflicted and the healthcare system? Is it indeed beneficial to have the patients back home within 48 hours, and is their risk of infection really lower?

This may well be the case but proof is, by nature of the novelty and spontaneity of this approach, scarce to absent. One might just as well argue that this line of action is playing with the general insecurity of both patients and the medical community regarding the pandemic. It seems to be obliging the immense outside pressure from severely ill patients who require that their treatment is not postponed.

A pro argument for the suggested change in practice would be that it is better to get a potentially suboptimal treatment than none or dying on the list. A contra argument would be to insinuate that monetary reasons, both industry and hospital driven, help to outweigh ethical reservations. Keeping a rational balance is, as so often with competing possibilities and interests, no easy undertaking. It should, however, be the task of learned societies to advise their members to be extremely careful with a deviation from established guidelines – especially under the difficult circumstances in presumed “wartimes”.

Publication History

Article published online:
14 March 2021

• Reference

• 1 Begley L. Wartime Lies. Alfred Knopf; New York: 1991. ISBN: 0-679-40016-8