Are there any situations when a physician is justified in lying to a patient?

"I understand that the only reason a physician should withhold information from a patient is under the premise of therapeutic privilege. This concept describes situations where a patient could be a threat to themselves if the physician fully disclosed the details of their medical situation. This is generally referring to the patient being a psychological threat to themselves. Although there is support for this idea, I do not feel that it should be exercised unless the case is extreme. Physicians have a fiduciary duty to their patients which must be taken seriously."