Medical Ethics PHIL 148 @ Binghamton University, Sum 11


Sample Debate

Below is a Position Post for a Debate Day.  It earned a 3.  Please write a Response Post critiquing this position.  Even without having read on this particular topic (you'll have a chance next week).  Use the ethical theories and concepts you have learned this week to talk about the issues raised by this post.  As a guide, here are some questions from the Learning Packet:

  • What is your position?
  • Do you think your position is clear to others?  Are you sure?
  • Is your argument clear to others?  Hint: Be explicit; spell everything out.
  • What details do you think are ethically relevant in the debate?
  • What do the other Group Leaders think is ethically relevant?
  • What facts support your side of the debate?
  • How can these facts be combined with ethical arguments to support your position?
  • Do these facts contradict or support one another?
  • Can these facts be used to draw other conclusions?
  • What ethical perspective are you arguing from?
  • What ethical perspective are the other Group Leaders arguing from?
  • What side of the debate do you favor intuitively?
  • What side do you find most convincing independent of your intuitions?

Debate Question: Should Doctor's Ever Lie to Their Patients?

Position Post: Despite popular belief, doctors should be able to lie and withhold information from their patients. When looking at the issue broadly, one may immediately think that the truth always prevails and that one should have control over their own body, but when different scenarios are examined, it is clear that in certain types of cases, withholding information is the most moral option. There are two ethical perspectives which would support withholding information. Utilitarianism says that the moral thing to do is what is best outcome for the well being of the most amount of people. It is not the motive of the person that matters, so the fact that a doctor is lying is not morally relevant. The doctor is producing the best possible outcome, and out of all parties involved, is best fit to analyze all options and choose what is best for the patient and the community. In the example provided in the Thomasma article, the author describes a situation in which a mildly retarded woman has ambiguous genitalia.  Disclosing the truth can only ruin this woman's life. There is no possible positive outcome from disclosing the truth; her condition is not life threatening; knowledge of her condition could not improve the quality of her life. It could only damage her feelings and self worth, and the relationships with those around her. In this case, utilitarianism would suggest that withholding the information is the moral thing to do.

Care ethics could also be used to argue for the right to lie and withhold information. According to Beauchamp, care ethics stresses that individual attachments are what is morally relevant. He says that without the basic level of care, there would be no human race. Plus, the ability to put another before one's self is an important point in care ethics. In lying to a patient, a doctor is really putting the patient's well being before his own. A doctor can very well be sued by a patient who finds out that a doctor lied about their condition or withheld information. The doctor didn't lie to be mean; he wasn't lying for any personal gain because he was putting his own career at risk because he believed that lying would really be better for the patient's well being.  Doing such an act is selfless and is putting the patient before his own career and legal standing in the medical field. Plus, the relationship between the doctor and patient can sometimes become really close, and a patient may choose that they wouldn't want to know something. A doctor and a patient they have been treating for a long time establish a high level of trust, which lets the doctor in on how a patient might react.

Sometimes, offering a patient full disclosure is a death sentence, even if their condition isn't necessarily a death sentence. Patients are often stressed with their medical issues and can't make objective decisions or handle new information that must make them reexamine their life. As a person who is not sick, I know there are situations in which I would not want to know the full details of a hypothetical condition if I faced it. In the case Thomasma described in which a dying victim of a car accident asked about their other family members who were already dead, lying is most definitely the moral thing to do. The man may very well die himself in the next few hours, plus even if he has a chance to get better, devastating news like that will only make him further deteriorate and not get better. It is only cruel to tell him such news that his entire family is dead. Sometimes, motivation is what is needed to improve a patient's condition, and such can only be provided through false information. Putting positive thoughts into a child's head who has cancer sometimes helps them progress more quickly, which is not done by giving the child every detail and statistic of their condition. This concept can be applied to adults and might speed their recovery if some of their autonomy were taken away.

Thomasa also stresses that although truth is essential for healing an illness, it may not be as important for curing a disease. Illness and disease are two separate entities which must be treated differently, and most of the time when truth is withheld, it is only temporary. When doctor's take a Hippocratic oath, they swear to do what is good for their patients and treat them to the best of their ability. In reality this sometimes involves actions like lying or withholding information. The idea of necessary paternalism deems it necessary for doctors to sometimes act to protect patients from harm.

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