Commentary on the paper 'Dementia diagnosis and white lies: a necessary evil for carers of dementia patients?'

‘Thou shalt not lie’; ‘the truth, the whole truth, and nothing but the truth’. Both morality and the law contain clear statements about the importance of veracity. Yet, as Ginny Russell so eloquently describes, based upon personal experience with her mother in the UK, truth telling in dementia is fraught with problems. The problems are not only ethical, but can also be practical and emotional. They can arise on a daily basis for the family and friends of people with dementia, as well as for care staff and professionals. The author’s conclusion about lying as ‘a necessary evil’ can be viewed as a pragmatic resignation to a complex issue. This is a place many people reach following a difficult journey involving challenges and compromises to their values, beliefs, integrity and (for practitioners) aspects of their professionalism. Yet, perhaps there is a way of framing ‘non-truth telling’ in a more positive way, without ignoring the dilemmas that it inherently contains.