We grow up being told to always tell the truth. But parents inevitably send a more nuanced message when we hear them tell a half truth, or tell untruths out of kindness, or remain silent, perhaps to keep a promised confidence, and thereby send a false message.
My belief is that in the context of personal relationships, most people, including those of essentially good character, lie when the stakes are high enough, especially if the ends appear to justify the means
So, my eyebrows lift when 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 was never accepting of “situational ethics,” a concept endorsed by many notable philosophers and theologians in the 1960s, asserting that ends justify the means as long as the act is taken in the name of love. She always regarded my outlook as far too tolerant of those who fail to tell the truth, or who at best hide behind ambiguity. A fan of Bill Clinton until he was trapped by the blue dress, she never forgave his failure to tell the truth, even though she readily excused his sexual transgressions.
I decided to probe, to put her convictions to a test. I asked, “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 recently heard about a study done some years ago by Dr. Victor Freeman (when he served as a Research Fellow at Georgetown University Medical Center)*. He 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 insurance company policies designed to keep costs in check, 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?”
“Not fair”, she said, her lips tight. 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 outweigh 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?
Food for thought, and further discussion. **