BCIT Term Spring 2009

Course LIBS 7002 (Applied Ethics)

Instructor Brian Thomas
Due Date June 17, 2009
Student Arthur Kenzie (A00242330)

“My mother, a dermatologist, told me (without revealing confidential

information) that a young teenager who smoked cigarettes came to her
office with acne. My mother advised her that the acne would not clear up
until she stopped smoking. In truth, only the prescription medication was
needed. My mother said that she was only trying to improve the health of
her patient. Was she right?”

Deception cannot usually be morally justified, but in this case I believe

that the dermatologist mother is on relatively solid ground. The deception
foisted on the young teenage patient was that there is a causal relationship
between smoking and acne. This reminds me of many of the allegorical
stories in the Bible, with the ultimate goal being to change the behaviours
and attitudes of the reader for their own benefit and enlightenment. The
Promised Land of greater health is a worthy goal indeed.

The highly principled will surely rebel idealistically at the falseness of

means, the potential for loss of credibility, the damage to honour and truth.
But even the first formulation of Kant’s categorical imperative could support
the mother’s choice in this matter: “An action is morally right for a person in
a certain situation if, and only if, the person’s reason for carrying out the
action is a reason that she would be willing to have every person act on, in
any similar situation”. Her reason for using deception was, I presume, to
help this young teenager make better choices for herself. She wanted her to
weigh for herself the coolness of smoking against the natural beauty of her

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acne-free skin. Surely, she would want everyone to act with such
consideration and intent.

Kant’s second formulation of his categorical imperative also appears to

me to support the mother’s action: “An action is morally right for a person if,
and only if, in performing the action, the person does not use others merely
as a means for advancing her own interests, but also respects and develops
their capacity to choose freely for themselves”. There are no apparent
motives for the mother to advance her own interests. The young teenager is
her only concern here, both in the specific instance of her skin, and in the
general instance of her health and her improved ability to make choices for
herself.

From what I consider to be a less principled perspective, utilitarianism,

the mother was surely right in her choices. There are considerable net
benefits to helping young teenagers choose not to smoke. On the plus side,
our society as a whole benefits from not having to bear the considerable
financial burden of caring for smokers when they inevitably encounter health
problems caused by their smoking. Second-hand smoke is also reduced,
ensuring that non-smokers are not impacted in the same way as smokers.
Individuals achieve health benefits such as reduced heart, pulmonary, and
respiratory diseases, reduced instances of cancer, and longer life
expectancy. As well, there are individual personal benefits such as improved
senses of taste and smell, more opportunity to save money, greater self-
esteem from being able to resist or conquer addiction to nicotine, and from
setting a better example for children and others.

There are costs to be considered in the utilitarianism analysis, to be

sure. The cost of the deception in terms of lost trust by the young teenager

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for her doctor, and possibly for authority figures in general, could be
considerable. This lost trust could also easily transform into rebellion, which
might extend and amplify the costs such that her future choices may be
driven by a need to do the opposite of what she is being told to do. There is
a cost for the dermatologist mother as well, since she will have to face either
her own guilt, or her compromised personal integrity. Both of these are
slippery slopes, and she will have to guard against using deception on a
regular basis, as opposed to using it for its achievement of greatest benefit
in a specific instance such as this. She will also have to guard against any
increased inclination to be imposing her own views on others at
inappropriate times.

If the patient discovers the deception, or believes it to be an error, and

challenges her dermatologist, then the scenario is altered and different. How
the doctor handles this possibility, and how the doctor follows up on her own
initiative with her patient, are critical moral tests. I would argue, in fact, that
it would be at this time, in these subsequent interactions, that the ethics of
the doctor’s choice would most appropriately be evaluated.

Young teenagers have difficulty making good choices at times. Young

teenage girls who smoke are fairly stereotypical and predictable in our
society, and most would agree that they require a different approach,
different leverage, to get their attention. I believe that there are sufficient
net benefits, as per a utilitarian perspective, to warrant using allegories and
limited deceptions, as the doctor has done in this case, in any attempt to
manage their behaviours and help them learn about themselves. I also
believe that the motives, and perceived duties, of the doctor support the
deontological perspective that she was making the right choice.

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