My eyebrows lift as my friend says: I can tolerate anything but being lied to.

    Noting my skeptical glance, her irritation shows. Honesty, as an absolute, has been a topic of contention with us over the years, she regarding my outlook as far too tolerant of those who fail to tell the truth, or even those who hide behind ambiguity.

    My belief is that most people,including those of essentially good character, lie when the stakes are high enough, especially if the ends appear to justify the means. She was a Bill Clinton fan, until he was trapped by the blue dress. Since, she has never forgiven his failure to tell the truth, even though she readily forgave his sexual transgressions.

    I decide to probe, put her convictions to a test. I ask: Would you hire a professional who believed it ethical to perpetrate an important deception?

    Her quick response: of course not.

    My question was a set-up.

    I told her I'd heard about a study done a few years ago by Dr. Victor Freeman (when he served as a Research Fellow at Georgetown University Medical Center). Freeman surveyed 167 doctors, internists from around the country, and asked: If an insurance company initially refuses to pay for a patient's medically indicated treatment, is it ethical for a doctor to lie to get the coverage authorized?

    Forty-five percent of those asked, answered "yes" and, not surprisingly, the more potentially life-saving the coverage, the stronger the support expressed for lying. The results underscored the fundamental conflict that many doctors have about HMOs, particularly in markets where there are severe constraints.     

     It's not hard to place myself in the shoes of a physician willing to practice deception, if they saw no other way for their patient to receive medically indicated treatment.

     So, I asked my friend, with a certain smugness: which physician would you select to treat a loved one?

     Her lips stretched tight and she said: not fair.

     But, hardly a moment passed before she rejoined: and you, would you hire a lawyer who acknowledged regularly practicing outright deception?  

     I was silenced, for I would not.

     So, now it is my stance that calls for an explanation if I am to support the distinction posed: Does securing a patient's physical well-being trump the social or financial advantage, or even the liberty, that deception might yield for the lawyer's client? Even if the illness was not life-threatening and the threat to liberty great?

     Apparently so.

     Food for thought, and further discussion.