Truth in Context

One of the most basic moral concepts that children are taught from a young age is that “lying is wrong”, of course, we see as we age that lying is completely social acceptable, and at times socially required.

As moral philosophers, we understand that we should lie if it will protect someone from bodily harm, even if lying is not a universalize action (sorry Kant), but as people we realize that lying smooths over social relations, spares feelings, and can oftentimes be harmless). When we make the decision to lie, believing that lying is the best course of action not just for ourselves, but for others that we are lying to, we are privileging some other value over truth-telling. This reminds us of two things about ethics: first, that all of our actions must be contextualized, and two, that choosing a right action is almost always going to involve conflicting values that we must choose between and that acting rightly is not simply a matter of following rules, because those rules will inevitably at some point clash.

This is not to say that lying is always okay. Of course, lies that only benefit the perpetrator and may cause harm are not okay. Lies that violate consent are similarly not okay- this is why cheating in romantic relationships is wrong because it violates one party’s consent to the relationship when that consent is based on monogamy. The real question of course, is how do we determine when consent and the ability to make autonomous choices are at risk when we lie? How do we determine when these values are more important than values such as preventing harm or promoting the good (such as when we boost our friends self-esteem through a lie, or affirm that everything will be okay when we know it might not be)?

In Medical Contexts

This question becomes even more fraught when it is applied to the medical context. While most patients would say that they would want their doctor to tell them of a terminal diagnosis, or the progression of a debilitating disease, not all doctors are convinced that they should acquiesce to these desires.

This is because there are conflicting values at play.  In “Should Doctors Tell the Truth?” Phillip Collins, a physician and philosopher argues that in general, doctors should not tell the truth to their patients in terminal situations. He argues this both because of his personal experiences where upon getting a terminal diagnosis, patients become depressed and lose the will to live, or where instead of taking care of themselves and accepting treatment that might improve their outcomes, they instead run themselves into the ground.

Collins therefore, has decided that in general, if doctors are to do good and prevent harm, they must lie to patients. This is obviously a paternalistic stance, but on the basis of the consequences alone, he may be correct.

However, there are other consequences to lying. While patients may make bad decisions because they are informed, they may also make bad decisions because they are uninformed.  For example, a patient may just as easily be driven to accomplish their goals and repair relationships as a result of a terminal diagnosis as they are driven to despair. When doctors choose to lie to their patients they deprive them of the choices they might make given that information, and doctors are not all psychologists, and cannot truly know how a patient may respond to the information.

There is no easy answer to this question, just as there is no easy answer to the question of whether or not you should tell your friend that the hideous outfit they are in love with looks great and send them out to the world in it. (Just for the record, I am the friend with the hideous outfit, and yes, I know it’s hideous and I will bless the world with the happiness it gives me regardless).

Making Choices

In general, I fall on the side of truth-telling. This is because, especially as we age, what may be good for one person may not be good for another. We each conceive of our own conceptions of the good and only we can chart the course of our life in such a way that we can reach that conception. If that conception includes ignorance, that is of course, a valid choice. This is even truer in jurisdictions where medical assistance may not be available for those with certain types of conditions, and when nothing can be done about something why bother worrying?

However, in cases where the information would change the equation, where it would a person to make meaningfully different choices that would lead them to their own construction of the good, then that information needs to be released to them.

We can be true and kind at the same time, and we can do our best to ensure that our words do not lead to negative outcomes, but some choices we can only make for ourselves, and only if we are fully informed.

 

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