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Don’t Lie! . . . Why Not?: How to Argue for Truthfulness in Medical Practice

Abstract

You have lied! You are a liar! This is one of the most serious moral offences one can be blamed for. Augustine even regards lying as the fundamental moral offence and identifies it with sin and evil in general. For Augustine and Kant, lying is in itself morally reprehensible and not justifiable at all.

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1. Cf. Barnes JA.A Pack of Lies: Towards a Sociology of Lying. Cambridge: Cambridge University Press; 1994.

2. Bok S.Lying: Moral Choice in Public and Private Life. New York: Vintage; 1999.

3. Dietz S.Der Wert der Lüge. Über das Verhältnis von Sprache und Moral. Paderborn: Mentis; 2002.

4. Cf. Augustine. Lying. In: Deffari RJ, ed. St. Augustine: Treatises on Various Subjects. Washington, DC: Catholic University of America Press; 1965:60–1.

5. Cf. Beauchamp TL, Childress J.Principles of Biomedical Ethics. New York/Oxford: Oxford University Press; 1994, at 120.

6. Following W. D. Ross and his conception of prima facie obligation—“that is an obligation that must be fulfilled unless it conflicts on a particular occasion with an equal or stronger obligation”—Beauchamp and Childress understand the biomedical principles as prima facia binding. See note 5, Beauchamp, Childress 1994, at 33 and 103–5.

7. In this article, I am only concerned with basic moral concepts or principles that I regard as fundamental for moral and legal duties in Kant’s system of moral philosophy. According to this understanding (which is controversial in the literature about Kant), the categorical imperative is, as the highest law of morality, constitutive both for the doctrine of right and for the doctrine of virtue. Therefore, Kant uses a “moral concept of right” (Kant I. Metaphysics of Morals. London: Cambridge University Press; 1996, at 23) in the same fundamental moral sense as he uses a moral concept of virtue. The important difference between these two parts of moral philosophy lies on the level of more concrete duties, such as, on the one hand, the lying of a doctor to a patient whereby he violates the legal rule of informed consent with harmful consequences for the patient and, on the other hand, lying in a (merely) moral or virtual sense that does not (necessarily) harm anyone and that is not legally prosecuted.

8. See note 4, Augustine 1965, at 54.

9. See note 4, Augustine 1965, at 60.

10. See note 4, Augustine 1965, at 55.

11. Kant I. On a supposed right to lie from altruistic motives. In: Kant I.Critique of Practical Reason and Other Writings in Moral Philosophy. Chicago: University of Chicago Press; 1949, at 347.

12. See note 7, Kant 1996, at 184.

13. Cf. Kant I.Lectures on Ethics. London: Cambridge University Press; 1997, at 201.

14. See note 2, Bok 1999, at 38.

15. Augustine. The Enchiridion on Faith, Hope, and Charity (§ 18). New York: New City Press; 1999, at 49.

16. Augustine. Quaestionum in Heptateuchum libri septem. III 68. Quoted and translated from: Keseling P. Einführung. In: Augustinus. Die Lüge und Gegen die Lüge. Würzburg: Augustinus-Verlag Würzburg; 1953, at XXV.

17. See note 11, Kant 1949.

18. See note 11, Kant 1949.

19. See note 11, Kant 1949.

20. See note 11, Kant 1949, at 350.

21. Kant I. Introduction to the metaphysics of morals. In: Kant I.Metaphysics of Morals. Cambridge: Cambridge University Press; 1996, at 16.

22. Cf. Williams B.Morality: An Introduction to Ethics. London: Cambridge University Press; 1976, chapter 10.

23. Kant I. Metaphysical first principles of the doctrine of right. In: Kant I.Metaphysics of Morals. London: Cambridge University Press; 1996, at 28.

24. See note 13, Kant 1997, at 204.

25. See note 11, Kant 1949.

26. Kant I. Groundwork of the Metaphysics of Morals. New York: Harper & Row; 1964, at 96.

27. See note 7, Kant 1996, at 182.

28. See note 11, Kant 1949.

29. See note 23, Kant 1996, at 105. Here, Kant distinguishes between the “innate personality” (angeborene Persönlichkeit) and the “civil personality” (bürgerliche Persönlichkeit). The innate personality cannot be lost, according to Kant; it protects any human being from becoming a mere thing others may have rights to, whereas “he can be condemned to lose his civil personality.”

30. See note 11, Kant 1949, at 349.

31. “Respect for autonomy” means, according to Beauchamp and Childress, “respect for the autonomous choices of other persons.” See note 5, Beauchamp, Childress 1994, at 120.

32. Cf. Rehbock T. Personsein in Grenzsituationen: Zur Ethik der Kritik medizinischen Handelns. Paderborn: Mentis; 2005, chapter x.

33. Cf. Rehbock T.Limits of autonomy in biomedical ethics? Conceptual clarifications. Cambridge Quarterly of Healthcare Ethics 2011;20:524–9.

34. See note 15, Augustine 1999 (§ 22), at 55.

35. See note 7, Kant 1996, at 182.

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Cambridge Quarterly of Healthcare Ethics
  • ISSN: 0963-1801
  • EISSN: 1469-2147
  • URL: /core/journals/cambridge-quarterly-of-healthcare-ethics
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