I would phrase the issue of TOGOM differently. If Clark had seen Lois' pain as Superman, I am 100% sure he would have told her. Whether he should tell her at that point, I am less certain, but to willingly let her go through so much pain, I do not think he would have.
He even falls alseep as she is telling him how she feels. Personally I think if he had not he would have told her. Not that he should have told her neccesarily, but I think he would have felt compelled to tell her.
Actually, I think if he had been awake he would have ended up telling her because he would have said something to imply he had not realized her pain, not considered in his thought how much he was in pain, and she would have figured it out/forced it out of him even if he had not told her.
